Provider Demographics
NPI:1669124053
Name:EMERGE PROSTHETIC ARTS, LLC
Entity type:Organization
Organization Name:EMERGE PROSTHETIC ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:626-372-0317
Mailing Address - Street 1:171 WESTCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-8691
Mailing Address - Country:US
Mailing Address - Phone:626-372-0317
Mailing Address - Fax:
Practice Address - Street 1:131 COLUMBIA AVE E STE 211
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3761
Practice Address - Country:US
Practice Address - Phone:626-372-0317
Practice Address - Fax:269-231-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier