Provider Demographics
NPI:1043540784
Name:IPGDX, LLC
Entity type:Organization
Organization Name:IPGDX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEAL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:989-724-5631
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48740-0253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:705 S LAKE HURON SHORE DR
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9593
Practice Address - Country:US
Practice Address - Phone:989-724-5631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment