Provider Demographics
NPI:1083982615
Name:EMERGENT HEALTHCARE LLC
Entity Type:Organization
Organization Name:EMERGENT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, ASN
Authorized Official - Phone:505-285-0757
Mailing Address - Street 1:1604 E SANTA FE AVE
Mailing Address - Street 2:SUITE 224
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-4006
Mailing Address - Country:US
Mailing Address - Phone:505-285-0757
Mailing Address - Fax:505-216-2642
Practice Address - Street 1:1604 E SANTA FE AVE
Practice Address - Street 2:SUITE 224
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-4006
Practice Address - Country:US
Practice Address - Phone:505-285-0757
Practice Address - Fax:505-216-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health