Provider Demographics
NPI:1174096218
Name:MARORIE HOMECARE LLC
Entity type:Organization
Organization Name:MARORIE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NDUKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-265-4357
Mailing Address - Street 1:10203 ALOUETTE DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-4110
Mailing Address - Country:US
Mailing Address - Phone:908-265-4357
Mailing Address - Fax:
Practice Address - Street 1:8501 TOWER POINT DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7849
Practice Address - Country:US
Practice Address - Phone:908-265-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care