Provider Demographics
NPI:1427760206
Name:MERAKI ESSENTIAL HEALTH LLC
Entity type:Organization
Organization Name:MERAKI ESSENTIAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYJHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-341-8852
Mailing Address - Street 1:1520 N 7TH ST # R1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3769
Mailing Address - Country:US
Mailing Address - Phone:215-341-8852
Mailing Address - Fax:
Practice Address - Street 1:1520 N 7TH ST # R1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3769
Practice Address - Country:US
Practice Address - Phone:215-341-8852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health