Inform Diagnostics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INFORM DIAGNOSTICS, INC.

Practice address

101B Villa Dr
Suite 108
Daphne, AL 36526-4653

Phone

(800) 979-8292

NPI assigned

Apr 12, 2017

Last updated

Apr 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bonnie Sue Pirtz

Title

VP, Managed Care

Phone

(480) 309-2674

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1790219137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 N MACARTHUR BLVD",
            "address_2": "ATTN: MANAGED CARE DEPARTMENT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392443",
            "telephone_number": "214-596-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101B VILLA DR",
            "address_2": "SUITE 108",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264653",
            "telephone_number": "800-979-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORM DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "PIRTZ",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "VP, MANAGED CARE",
        "authorized_official_telephone_number": "480-309-2674"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy M Iliff, MD
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• Injury Med Express Pharmacy LLC (Injury Med Express Pharmacy)
• Inspired Angels of Care, LLC
• Integral Alignment, Inc. (Filed for Dba Healthsource of Daphne) (HealthSource of Daphne (filed for))
• Integrated Specialty Clinic LLC
• Integrative Healthcare of Lower Alabama

• Clinical Medical Laboratory in Daphne, AL
• Providers in Daphne, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.