Healthcare Provider Details

I. General information

NPI: 1003071192
Provider Name (Legal Business Name): INTERACTIVE MEDICAL SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 SHORELINE DR UNIT 3406
MOUND MN
55364-1630
US

IV. Provider business mailing address

2811 E ANA ST SUITE B
COMPTON CA
90221-5601
US

V. Phone/Fax

Practice location:
  • Phone: 800-225-9080
  • Fax: 800-382-3573
Mailing address:
  • Phone: 800-225-9080
  • Fax: 800-382-3573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: VANESSA JONES
Title or Position: BUSINESS ANALYST
Credential:
Phone: 800-225-9080