Provider Demographics
NPI:1912203712
Name:EMEDICAL GROUP INC
Entity Type:Organization
Organization Name:EMEDICAL GROUP INC
Other - Org Name:EMEDICALGROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MARIA LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-740-5252
Mailing Address - Street 1:299 PRAIRIE ST N
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-1618
Mailing Address - Country:US
Mailing Address - Phone:334-738-7337
Mailing Address - Fax:334-738-7339
Practice Address - Street 1:299 PRAIRIE ST N
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:36089-1618
Practice Address - Country:US
Practice Address - Phone:334-738-7337
Practice Address - Fax:334-738-7339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22602261QH0100X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service