Provider Demographics
NPI:1275373490
Name:EMMA'S HYDRATION THERAPY LLC
Entity type:Organization
Organization Name:EMMA'S HYDRATION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:256-417-2607
Mailing Address - Street 1:600 BOULEVARD SOUTH SW STE 104
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2175
Mailing Address - Country:US
Mailing Address - Phone:256-417-2607
Mailing Address - Fax:
Practice Address - Street 1:600 BOULEVARD SOUTH SW STE 104
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2175
Practice Address - Country:US
Practice Address - Phone:256-417-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty