MEDICARE: MELICARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	008627	TX

General Provider Information

NPI Number	:	1437106184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELICARE INC

Provider Business Mailing Address
First Line	:	16146 GREENWELL SPRINGS RD
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-4118
Country	:	US
Telephone Number	:	225-262-7770
Fax Number	:	225-262-7772

Provider Business Practice Location Address
First Line	:	2615 E END BLVD S
Second Line	:	SUITE 300
City	:	MARSHALL
State	:	TX
Zip	:	75672-7425
Country	:	US
Telephone Number	:	903-938-5858
Fax Number	:	903-938-5859

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN M WHITWORTH SR.
Credential	:
Telephone Number	:	225-262-7770

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/22/2020

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