Provider Demographics
NPI:1760669600
Name:EMD MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:EMD MEDICAL SERVICES LLC
Other - Org Name:CHERRY FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TARUFELLI
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:602-639-1320
Mailing Address - Street 1:36470 N. 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:928-634-1304
Mailing Address - Fax:928-634-2887
Practice Address - Street 1:18850 E. SCHOOLHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:BLACK CANYON CITY
Practice Address - State:AZ
Practice Address - Zip Code:85324
Practice Address - Country:US
Practice Address - Phone:623-374-5215
Practice Address - Fax:623-374-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2353261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center