MEDICARE: WILLARD EMERY

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1447489323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLARD EMERY

Provider Business Mailing Address
First Line	:	172 MEDFORD RD
Second Line	:
City	:	MILO
State	:	ME
Zip	:	04463-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	172 MEDFORD RD
Second Line	:
City	:	MILO
State	:	ME
Zip	:	04463-1523
Country	:	US
Telephone Number	:	207-852-0134
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLARD EMERY
Credential	:
Telephone Number	:	207-852-0134

Provider Enumeration Date	:	07/13/2009
Last Update Date	:	07/13/2009

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Directions to “WILLARD EMERY ” Practice Location

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