Provider Demographics
NPI:1871799411
Name:EMERALD GREEN ENTERPRICES,INC.
Entity type:Organization
Organization Name:EMERALD GREEN ENTERPRICES,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-764-8840
Mailing Address - Street 1:12716 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-5031
Mailing Address - Country:US
Mailing Address - Phone:818-764-8840
Mailing Address - Fax:818-764-8181
Practice Address - Street 1:12716 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5031
Practice Address - Country:US
Practice Address - Phone:818-764-8840
Practice Address - Fax:818-764-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5036800001Medicare ID - Type Unspecified