MEDICARE: EMISSIONIST 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1538052162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMISSIONIST LLC

Provider Business Mailing Address
First Line	:	312 W 2ND ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2412
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 W 2ND ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2412
Country	:	US
Telephone Number	:	929-293-5682
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZOHAN KHAN
Credential	:
Telephone Number	:	929-293-5682

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “EMISSIONIST LLC ” Practice Location

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