Healthcare Provider Details

I. General information

NPI: 1437809985
Provider Name (Legal Business Name): IMPAX SOLUTIONS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 W FLETCHER ST
PHILADELPHIA PA
19132-3427
US

IV. Provider business mailing address

PO BOX 13344
PHILADELPHIA PA
19101-3344
US

V. Phone/Fax

Practice location:
  • Phone: 856-956-6258
  • Fax:
Mailing address:
  • Phone: 856-956-6258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MISS SAESHA SAMPSON
Title or Position: TREASURER
Credential: IT SUPPORT
Phone: 856-956-6258