Provider Demographics
NPI:1124702667
Name:EMANUEL, ANDREW M
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:EMANUEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33204 W LOOP RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51108-8530
Mailing Address - Country:US
Mailing Address - Phone:712-389-7944
Mailing Address - Fax:
Practice Address - Street 1:33204 W LOOP RD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51108-8530
Practice Address - Country:US
Practice Address - Phone:712-389-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)