Provider Demographics
NPI:1114603255
Name:EMPASS MEDICAL SERVICES, P.A.
Entity Type:Organization
Organization Name:EMPASS MEDICAL SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHONNIUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEMWENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-261-6542
Mailing Address - Street 1:609 GREENWICH ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3610
Mailing Address - Country:US
Mailing Address - Phone:212-261-6542
Mailing Address - Fax:
Practice Address - Street 1:609 GREENWICH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3610
Practice Address - Country:US
Practice Address - Phone:212-261-6542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251E00000XAgenciesHome Health
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No347C00000XTransportation ServicesPrivate Vehicle