Provider Demographics
NPI:1790183895
Name:EMBLEM HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EMBLEM HEALTHCARE, INC.
Other - Org Name:EMBLEM HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:1400 E SOUTHERN AVE STE 1010
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-8009
Mailing Address - Country:US
Mailing Address - Phone:480-444-7800
Mailing Address - Fax:480-444-9930
Practice Address - Street 1:1400 E SOUTHERN AVE STE 1010
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-8009
Practice Address - Country:US
Practice Address - Phone:480-444-7800
Practice Address - Fax:480-444-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
037253Medicare Oscar/Certification