Healthcare Provider Details
I. General information
NPI: 1831349364
Provider Name (Legal Business Name): EMERALD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2008
Last Update Date: 09/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2552 POPLAR AVE STE 406
MEMPHIS TN
38112-3834
US
IV. Provider business mailing address
2552 POPLAR AVE STE 406
MEMPHIS TN
38112-3834
US
V. Phone/Fax
- Phone: 901-324-0737
- Fax: 901-324-0738
- Phone: 901-324-0737
- Fax: 901-324-0738
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
FELICIA
T
DILLON
Title or Position: CEO
Credential:
Phone: 901-324-0737