Provider Demographics
NPI:1790309284
Name:EMERIKA MOBILE HEALTH LLC
Entity Type:Organization
Organization Name:EMERIKA MOBILE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:419-688-1302
Mailing Address - Street 1:28 PARK AVE W STE 701
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902-1640
Mailing Address - Country:US
Mailing Address - Phone:419-688-1302
Mailing Address - Fax:
Practice Address - Street 1:28 PARK AVE W STE 701
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902-1640
Practice Address - Country:US
Practice Address - Phone:419-688-1302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1477191666OtherNPI