Provider Demographics
NPI:1932754710
Name:EICHORN, EMALEE MARGARET
Entity Type:Individual
Prefix:
First Name:EMALEE
Middle Name:MARGARET
Last Name:EICHORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 WAINWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3951
Mailing Address - Country:US
Mailing Address - Phone:419-631-9493
Mailing Address - Fax:
Practice Address - Street 1:3433 AGLER RD STE 2000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3397
Practice Address - Country:US
Practice Address - Phone:419-631-9493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5901279376J00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker