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General NPI Number Information
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NPI Number | 1073274312
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Entity Type | Organization
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Legal Business Name | INTELLIMED HEALTH
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Dates
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Enumeration Date | 01/09/2022
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Last Update Date | 01/09/2022
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Provider Practice Location Address
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Address Line | 2377 GOLD MEADOW WAY STE 100
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City | GOLD RIVER
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State | CA
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Zip | 95670-4444
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Country | US
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Telephone | 916-631-1987
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Fax |
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Provider Business Mailing Address
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Address Line | 2377 GOLD MEADOW WAY STE 100
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City | GOLD RIVER
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State | CA
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Zip | 95670-4444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. STEFANIE P
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Credential |
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Telephone | 305-814-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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