Healthcare Provider Details

I. General information

NPI: 1639771124
Provider Name (Legal Business Name): EMD TELEHEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CHINABERRY DR STE 800, 500
BOSSIER CITY LA
71111-2455
US

IV. Provider business mailing address

3800 VIKING DRIVE
BOSSIER CITY LA
71111-3526
US

V. Phone/Fax

Practice location:
  • Phone: 318-392-3372
  • Fax: 318-392-3373
Mailing address:
  • Phone: 318-392-3372
  • Fax: 318-392-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH MURRAY MONSOUR JR.
Title or Position: CEO
Credential:
Phone: 318-250-2587