Healthcare Provider Details

I. General information

NPI: 1912215203
Provider Name (Legal Business Name): EMERICARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 SANTA ROSA RD
CAMARILLO CA
93012-7101
US

IV. Provider business mailing address

6737 W WASHINGTON ST SUITE 2300
MILWAUKEE WI
53214-5647
US

V. Phone/Fax

Practice location:
  • Phone: 805-388-8086
  • Fax: 805-388-8450
Mailing address:
  • Phone: 414-918-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number050000554
License Number StateCA

VIII. Authorized Official

Name: MARK OHLENDORF
Title or Position: PRESIDENT
Credential:
Phone: 414-918-5000