Provider Demographics
NPI:1578146478
Name:PRECIOUS EMERALD HOMECARE INC
Entity Type:Organization
Organization Name:PRECIOUS EMERALD HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEMITOPE
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-639-9498
Mailing Address - Street 1:6439 N DAMEN AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5612
Mailing Address - Country:US
Mailing Address - Phone:312-639-9498
Mailing Address - Fax:
Practice Address - Street 1:6439 N DAMEN AVE APT 3S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5612
Practice Address - Country:US
Practice Address - Phone:312-639-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care