NPI Code Details Logo

NPI 1710291240

NPI 1710291240 : EMERITUS CORPORATION : CORDOVA, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1710291240
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    EMERITUS CORPORATION 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/26/2010
-----------------------------------------------------
    Last Update Date     |    05/17/2016
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1535 APPLING CARE LN 
-----------------------------------------------------
    City                 |    CORDOVA
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    38016-4927
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    901-377-7500
-----------------------------------------------------
    Fax                  |    901-377-1918
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6737 W WASHINGTON ST SUITE 2300
-----------------------------------------------------
    City                 |    MILWAUKEE
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53214-5647
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    EVP, CHIEF ADMIN. OFFICER
-----------------------------------------------------
    Name                 |     BRYAN  RICHARDSON 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    615-564-8131
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    310400000X
-----------------------------------------------------
    Taxonomy Name        |    Assisted Living Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    TN
-----------------------------------------------------

=====================================================
Legacy Identifiers
=====================================================
Identifier #1
-----------------------------------------------------
    Identifier Code      |    H445491
-----------------------------------------------------
    Identifier Type      |    MEDICAID
-----------------------------------------------------
    Identifier State     |    TN
-----------------------------------------------------
    Identifier Issuer    |    
-----------------------------------------------------

=====================================================
Proprietary Identifiers Ever Reported
=====================================================
Identifier #1
-----------------------------------------------------
    Identifier Code      |    H445491
-----------------------------------------------------
    Identifier Type      |    MEDICAID
-----------------------------------------------------
    Identifier State     |    TN
-----------------------------------------------------
    Identifier Issuer    |    
-----------------------------------------------------

                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.