Provider Demographics
NPI:1952850786
Name:IPMED LLC
Entity Type:Organization
Organization Name:IPMED LLC
Other - Org Name:IPMED LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-351-5665
Mailing Address - Street 1:3960 HOWARD HUGHES PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LAS VEGAS
Mailing Address - State:WA
Mailing Address - Zip Code:98027
Mailing Address - Country:US
Mailing Address - Phone:425-351-5665
Mailing Address - Fax:
Practice Address - Street 1:3960 HOWARD HUGHES PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-5972
Practice Address - Country:US
Practice Address - Phone:425-351-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare