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General NPI Number Information
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NPI Number | 1194229427
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Entity Type | Organization
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Legal Business Name | IMEX INC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 8251 MAYFIELD RD STE 105
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City | CHESTERLAND
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State | OH
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Zip | 44026
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Country | US
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Telephone | 216-504-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 6150 PARKLAND BLVD STE 110
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-4103
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Country | US
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Telephone | 216-504-0400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN TRANGLE
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Credential | MD, MBA
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Telephone | 216-504-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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