Provider Demographics
NPI:1598793267
Name:INMEDKO LLC
Entity Type:Organization
Organization Name:INMEDKO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-821-7979
Mailing Address - Street 1:1080 E PECOS RD STE 21
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2426
Mailing Address - Country:US
Mailing Address - Phone:480-821-7979
Mailing Address - Fax:480-821-7977
Practice Address - Street 1:1080 E PECOS RD STE 21
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2426
Practice Address - Country:US
Practice Address - Phone:480-821-7979
Practice Address - Fax:480-821-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty