Healthcare Provider Details

I. General information

NPI: 1851167027
Provider Name (Legal Business Name): EMERGING HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY STE 110
EUGENE OR
97401-8173
US

IV. Provider business mailing address

16100 SW 72ND AVE
PORTLAND OR
97224-7745
US

V. Phone/Fax

Practice location:
  • Phone: 458-247-3050
  • Fax:
Mailing address:
  • Phone: 971-290-2010
  • Fax: 877-290-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 971-290-2015