Provider Demographics
NPI:1538636014
Name:IMMUFOOD INC
Entity Type:Organization
Organization Name:IMMUFOOD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TZVIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEPAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-762-5135
Mailing Address - Street 1:609 ATTAIN ST STE 141
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1987
Mailing Address - Country:US
Mailing Address - Phone:919-762-5135
Mailing Address - Fax:
Practice Address - Street 1:609 ATTAIN ST STE 141
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1987
Practice Address - Country:US
Practice Address - Phone:919-762-5135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory