Healthcare Provider Details

I. General information

NPI: 1790183895
Provider Name (Legal Business Name): EMBLEM HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E SOUTHERN AVE STE 1010
TEMPE AZ
85282-8009
US

IV. Provider business mailing address

1400 E SOUTHERN AVE STE 1010
TEMPE AZ
85282-8009
US

V. Phone/Fax

Practice location:
  • Phone: 480-444-7800
  • Fax: 480-444-9930
Mailing address:
  • Phone: 480-444-7800
  • Fax: 480-444-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AMBER L TUELLER
Title or Position: SECRETARY
Credential:
Phone: 208-207-2726