Impact Technologies Group LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2009-00747 Issued in FL

Legal business name

IMPACT TECHNOLOGIES GROUP LLC

Doing business as

ITGMedical

Practice address

5401 N Haverhill Rd
Suite 125
West Palm Beach, FL 33407-7005

Phone

(561) 317-7546

Fax

(561) 296-6643

NPI assigned

Sep 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Angelina Ceja

Title

Ceo

Phone

(561) 317-7546

Specialties & licenses 2

Addresses

Other names 1

• ITGMedical Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1639302045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N HAVERHILL RD",
            "address_2": "SUITE 125",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334077005",
            "telephone_number": "561-317-7546",
            "fax_number": "561-296-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N HAVERHILL RD",
            "address_2": "SUITE 125",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334077005",
            "telephone_number": "561-317-7546",
            "fax_number": "561-296-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT TECHNOLOGIES GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "CEJA",
        "authorized_official_first_name": "ANGELINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-317-7546",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "2009-00747",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "2009-00747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ITGMedical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.