Provider Demographics
NPI:1447493770
Name:IMPRIMIS HEALTH GROUP
Entity type:Organization
Organization Name:IMPRIMIS HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-663-6952
Mailing Address - Street 1:3990 SHERIDAN ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3661
Mailing Address - Country:US
Mailing Address - Phone:954-963-1113
Mailing Address - Fax:954-206-6989
Practice Address - Street 1:3990 SHERIDAN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3661
Practice Address - Country:US
Practice Address - Phone:954-963-1113
Practice Address - Fax:954-206-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service