Provider Demographics
NPI:1427651017
Name:MYRTLE'S HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:MYRTLE'S HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:754-422-2834
Mailing Address - Street 1:6101 W ATLANTIC BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5157
Mailing Address - Country:US
Mailing Address - Phone:754-422-2834
Mailing Address - Fax:
Practice Address - Street 1:6101 W ATLANTIC BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5157
Practice Address - Country:US
Practice Address - Phone:754-422-2834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty