Provider Demographics
NPI:1235942707
Name:EMM MEDICAL CENTER GROUP INC
Entity type:Organization
Organization Name:EMM MEDICAL CENTER GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRICE III
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-873-6263
Mailing Address - Street 1:4320 W BROWARD BLVD UNIT A5
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3756
Mailing Address - Country:US
Mailing Address - Phone:561-873-6263
Mailing Address - Fax:
Practice Address - Street 1:4320 W BROWARD BLVD UNIT A5
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3756
Practice Address - Country:US
Practice Address - Phone:561-873-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center