Healthcare Provider Details

I. General information

NPI: 1518626704
Provider Name (Legal Business Name): IMPRUVON INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E BIDDLE ST
BALTIMORE MD
21213-3307
US

IV. Provider business mailing address

10900 UNIVERSITY BOULEVARD KATHERINE G. JOHNSON HALL, SUITE 147
MANASSAS VA
20110
US

V. Phone/Fax

Practice location:
  • Phone: 410-818-7272
  • Fax:
Mailing address:
  • Phone: 410-818-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN AMOYAL
Title or Position: CEO
Credential:
Phone: 410-818-7272