Provider Demographics
NPI:1720380587
Name:EMERGENT CARE PLUS
Entity Type:Organization
Organization Name:EMERGENT CARE PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SURRAT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:952-653-2525
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:952-653-2525
Mailing Address - Fax:
Practice Address - Street 1:4800 W 135TH ST
Practice Address - Street 2:SUITE 190
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-8720
Practice Address - Country:US
Practice Address - Phone:913-428-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGENT CARE PLUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site