Provider Demographics
NPI:1609000348
Name:INGENIUS 3 LLC
Entity Type:Organization
Organization Name:INGENIUS 3 LLC
Other - Org Name:I3 MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:OBENE
Authorized Official - Middle Name:GYAMFI
Authorized Official - Last Name:MANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-218-3192
Mailing Address - Street 1:18119 PRAIRIE AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3739
Mailing Address - Country:US
Mailing Address - Phone:310-218-3192
Mailing Address - Fax:
Practice Address - Street 1:18119 PRAIRIE AVE
Practice Address - Street 2:STE 104
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3739
Practice Address - Country:US
Practice Address - Phone:310-218-3192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies