Provider Demographics
NPI:1346808177
Name:EMERGENT FIRST CARE LLC
Entity Type:Organization
Organization Name:EMERGENT FIRST CARE LLC
Other - Org Name:EMERGENT FIRST CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAHR
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOMBA-FONJAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-205-2984
Mailing Address - Street 1:630 FREEDOM BUSINESS CTR DR FL 3
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1331
Mailing Address - Country:US
Mailing Address - Phone:610-205-2984
Mailing Address - Fax:484-930-1306
Practice Address - Street 1:630 FREEDOM BUSINESS CTR DR FL 3
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1331
Practice Address - Country:US
Practice Address - Phone:610-205-2984
Practice Address - Fax:484-930-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103695148Medicaid