Provider Demographics
NPI:1689046971
Name:IMEDEX
Entity type:Organization
Organization Name:IMEDEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:850-708-4288
Mailing Address - Street 1:516 OAKLINE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-4112
Mailing Address - Country:US
Mailing Address - Phone:850-708-4288
Mailing Address - Fax:
Practice Address - Street 1:516 OAKLINE DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-4112
Practice Address - Country:US
Practice Address - Phone:850-708-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies