Provider Demographics
NPI:1528376340
Name:IME PLUS, LLC
Entity Type:Organization
Organization Name:IME PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TTRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FULLERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-821-9100
Mailing Address - Street 1:7400 HANCOCK CT NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4591
Mailing Address - Country:US
Mailing Address - Phone:505-821-9100
Mailing Address - Fax:
Practice Address - Street 1:7400 HANCOCK CT NE
Practice Address - Street 2:SUITE D
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4591
Practice Address - Country:US
Practice Address - Phone:505-821-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty