Provider Demographics
NPI:1689334815
Name:IPM NURSE REGISTRY LLC
Entity type:Organization
Organization Name:IPM NURSE REGISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-822-7428
Mailing Address - Street 1:1401 VALLEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2074
Mailing Address - Country:US
Mailing Address - Phone:888-822-7428
Mailing Address - Fax:
Practice Address - Street 1:1401 VALLEY RD STE 2
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2074
Practice Address - Country:US
Practice Address - Phone:888-822-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450455178OtherSTATE OF NEW JERSEYDEPARTMENT OF THE TREASURY FILING CERTIFICATION