Provider Demographics
NPI:1225836596
Name:EMMALEC NURSING SERVICES LLC
Entity type:Organization
Organization Name:EMMALEC NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:NKONGHO
Authorized Official - Last Name:TABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-960-9799
Mailing Address - Street 1:6113 GRENFELL LOOP
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5337
Mailing Address - Country:US
Mailing Address - Phone:240-960-9799
Mailing Address - Fax:
Practice Address - Street 1:6113 GRENFELL LOOP
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5337
Practice Address - Country:US
Practice Address - Phone:240-960-9799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMMALEC NURSING SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care