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Emerged Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
EMERGED LLC13660442402020-11-15
Entity TypeOrganization
Provider OrganizationEMERGED LLC
Practice Office Address6507 S HARDY DR APT 224
TEMPE, AZ US
Practice Office Telephone6022288818
Mailing Address6507 S HARDY DR APT 224
TEMPE, AZ 852833590 US
Business Telephone6022288818
Authorized OfficialTACHUNDA BURKS, OWNER
6022288818
HPT Codes
CodeLicense NoState
174H00000X PRIMARY
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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