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General NPI Number Information
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NPI Number | 1790187342
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Entity Type | Organization
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Legal Business Name | EMESTON MEDIC
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 975 CORPORATE WAY SUITE H
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City | FREMONT
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State | CA
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Zip | 94539-6118
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Country | US
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Telephone | 925-727-8182
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Fax | 925-241-4072
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Provider Business Mailing Address
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Address Line | PO BOX 1566
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City | UNION CITY
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State | CA
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Zip | 94587-6566
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Country | US
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Telephone | 925-727-8182
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Fax | 925-241-4072
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Authorized Official
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Title or Position | OWNER
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Name | MR. EMMANUEL G UDOH
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Credential | PHARMACY TECHNICIAN
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Telephone | 925-727-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 107469
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License Number State | CA
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