Organization
EMINENCE HEALTHCARE STAFFING AGENCY LLC.
Active
Other names
Eminence Health & Notary Services
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI DAVONNE BROWN AAS (OWNER, MD, CEO)
(866) 350-6400
Entity
Organization
Contact information
Practice address
2015 W WESTERN AVE STE 201, SOUTH BEND, IN 46619-3558
(866) 350-6400
Mailing address
2015 W WESTERN AVE STE 201, SOUTH BEND, IN 46619-3558
(866) 350-6400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
27075427A
IN
261QH0100X
Health Service Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
305S00000X
Point of Service
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
347C00000X
Private Vehicle
—
IN
385H00000X
Respite Care
—
IN
Other
Enumeration date
02/20/2018
Last updated
08/22/2021
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