MEDICARE: EMBERTON AND COMPANY HOME HEALTH, 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	7615	OK

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	:	1659339992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBERTON AND COMPANY HOME HEALTH, LLC

Provider Business Mailing Address
First Line	:	2630 NW EXPRESSWAY STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7239
Country	:	US
Telephone Number	:	405-295-4300
Fax Number	:	405-295-4299

Provider Business Practice Location Address
First Line	:	2630 NW EXPRESSWAY STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7239
Country	:	US
Telephone Number	:	405-295-4300
Fax Number	:	405-295-4299

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LATOYA HOLLIMAN
Credential	:
Telephone Number	:	405-295-4300

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	06/14/2021

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