Provider Demographics
NPI:1366791840
Name:EMRIS LLC
Entity type:Organization
Organization Name:EMRIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NKEMDILIM
Authorized Official - Middle Name:
Authorized Official - Last Name:OMESIETE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:267-974-1783
Mailing Address - Street 1:8921 MAXWELL PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1517
Mailing Address - Country:US
Mailing Address - Phone:267-974-1783
Mailing Address - Fax:
Practice Address - Street 1:8921 MAXWELL PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1517
Practice Address - Country:US
Practice Address - Phone:267-974-1783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization