MEDICARE: EMERALD CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC0353	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154376028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERALD CARE LLC

Provider Business Mailing Address
First Line	:	3854 AMERICAN WAY STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4897
Country	:	US
Telephone Number	:	225-292-2031
Fax Number	:	225-295-9678

Provider Business Practice Location Address
First Line	:	1050 XRAY DRIVE
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-867-1141
Fax Number	:	704-864-3673

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	JOSHUA L. PROFFITT
Credential	:
Telephone Number	:	617-639-4092

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	04/06/2026

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