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General NPI Number Information
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NPI Number | 1619409034
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Entity Type | Organization
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Legal Business Name | BLUE EMERALD PORTFOLIOS LLC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1308 MINUTEMEN LN
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City | NORRISTOWN
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State | PA
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Zip | 19403-6318
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Country | US
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Telephone | 240-486-4761
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 MINUTEMEN LN
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City | NORRISTOWN
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State | PA
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Zip | 19403-6318
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Country | US
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Telephone | 240-486-4761
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR / OWNER
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Name | MS. THEMBISILE MASEKO
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Credential |
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Telephone | 240-486-4761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | PA
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