Healthcare Provider Details

I. General information

NPI: 1720845266
Provider Name (Legal Business Name): EMOCHA MOBILE HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 03/01/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 ASHLAND AVE # G26A
BALTIMORE MD
21205-1546
US

IV. Provider business mailing address

10807 FALLS ROAD P.O. BOX #828
BROOKLANDVILLE MD
21022
US

V. Phone/Fax

Practice location:
  • Phone: 410-864-8587
  • Fax:
Mailing address:
  • Phone: 410-864-8587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: JONATHAN THOUPOS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 410-982-1259