Provider Demographics
NPI:1306674320
Name:MARIKIEL HOME HEALTHCARE AGENCY INC.
Entity type:Organization
Organization Name:MARIKIEL HOME HEALTHCARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SOUKARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-501-8001
Mailing Address - Street 1:5300 SHAWNEE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2399
Mailing Address - Country:US
Mailing Address - Phone:571-501-8001
Mailing Address - Fax:
Practice Address - Street 1:5300 SHAWNEE RD STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2399
Practice Address - Country:US
Practice Address - Phone:571-501-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty