Provider Demographics
NPI:1043649882
Name:IMPLANTED PUMP MANAGEMENT LLC
Entity Type:Organization
Organization Name:IMPLANTED PUMP MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PUTRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-475-9635
Mailing Address - Street 1:1401 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2037
Mailing Address - Country:US
Mailing Address - Phone:201-475-9635
Mailing Address - Fax:201-475-9630
Practice Address - Street 1:1401 VALLEY RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2037
Practice Address - Country:US
Practice Address - Phone:201-475-9635
Practice Address - Fax:201-475-9630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion