MEDICARE: EMEND HEALTH AND WELLNESS 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	171100000X	Acupuncturist	0989	AZ

General Provider Information

NPI Number	:	1164944567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMEND HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	3255 S DORSEY LN APT 2013
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-3981
Country	:	US
Telephone Number	:	480-266-2657
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 S LINDSAY RD STE 111
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-1507
Country	:	US
Telephone Number	:	480-788-1757
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	ERIN WEST
Credential	:	LAC
Telephone Number	:	480-788-1757

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	05/16/2023

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