Provider Demographics
NPI:1851531909
Name:INNOVATED MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:INNOVATED MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DCOTT
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-396-9712
Mailing Address - Street 1:2920 NORTH SEVENTH STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291
Mailing Address - Country:US
Mailing Address - Phone:318-396-9712
Mailing Address - Fax:800-518-4235
Practice Address - Street 1:2920 NORTH SEVENTH STREET
Practice Address - Street 2:SUITE D
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-396-9712
Practice Address - Fax:800-518-4235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies