Provider Demographics
NPI:1013339555
Name:PRO-EPIC, LLC.
Entity type:Organization
Organization Name:PRO-EPIC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-805-1876
Mailing Address - Street 1:3595 INLAND EMPIRE BLVD BLDG 1
Mailing Address - Street 2:SUITE # 1250
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-7988
Mailing Address - Country:US
Mailing Address - Phone:909-373-4631
Mailing Address - Fax:909-373-4634
Practice Address - Street 1:3595 INLAND EMPIRE BLVD BLDG 1
Practice Address - Street 2:SUITE # 1250
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-7988
Practice Address - Country:US
Practice Address - Phone:909-373-4631
Practice Address - Fax:909-373-4634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
No242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionistGroup - Multi-Specialty
No246QB0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyBlood BankingGroup - Multi-Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No246QH0401XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHemapheresis PractitionerGroup - Multi-Specialty
No2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record TechnicianGroup - Multi-Specialty
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Multi-Specialty
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationGroup - Multi-Specialty