MEDICARE: UNIVERSAL IMPEX INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1376060780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL IMPEX INC.

Provider Business Mailing Address
First Line	:	6868 FARMCREST CIR NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-8827
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6868 FARMCREST CIR NW.
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720
Country	:	US
Telephone Number	:	347-613-7572
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NASIR MAJEED
Credential	:
Telephone Number	:	347-613-7572

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	08/25/2017

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