Provider Demographics
NPI:1639771124
Name:EMD TELEHEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:EMD TELEHEALTH SOLUTIONS LLC
Other - Org Name:EMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MONSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-392-3372
Mailing Address - Street 1:504 TEXAS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3526
Mailing Address - Country:US
Mailing Address - Phone:318-315-7093
Mailing Address - Fax:
Practice Address - Street 1:1000 CHINABERRY DR STE 800
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2455
Practice Address - Country:US
Practice Address - Phone:318-392-3372
Practice Address - Fax:318-392-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty