Provider Demographics
NPI:1366151888
Name:EMERGE HOME CARE LLC
Entity type:Organization
Organization Name:EMERGE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-589-9988
Mailing Address - Street 1:20600 ANTLER FARMS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-0630
Mailing Address - Country:US
Mailing Address - Phone:405-589-9988
Mailing Address - Fax:
Practice Address - Street 1:2500 S BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4039
Practice Address - Country:US
Practice Address - Phone:405-589-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHC8150OtherHEALTH DEPARTMENT