Provider Demographics
NPI:1598914418
Name:IMPLANTABLE TECHNOLOGIES LLC
Entity Type:Organization
Organization Name:IMPLANTABLE TECHNOLOGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:BURCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-273-7206
Mailing Address - Street 1:4514 COLE AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5412
Mailing Address - Country:US
Mailing Address - Phone:214-273-7206
Mailing Address - Fax:214-273-7207
Practice Address - Street 1:4514 COLE AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5412
Practice Address - Country:US
Practice Address - Phone:214-273-7206
Practice Address - Fax:214-273-7207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies