Provider Demographics
NPI:1275135030
Name:TURLEY, EMMANUEL E I
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:E
Last Name:TURLEY
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 GATEWAY BLVD S
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5446
Mailing Address - Country:US
Mailing Address - Phone:440-723-1682
Mailing Address - Fax:
Practice Address - Street 1:6380 GATEWAY BLVD S
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5446
Practice Address - Country:US
Practice Address - Phone:440-723-1682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0103046Medicaid