Provider Demographics
NPI:1275201329
Name:INNOVATIVE EMERGENCY MANAGEMENT, INC.
Entity type:Organization
Organization Name:INNOVATIVE EMERGENCY MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TIFFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-952-8229
Mailing Address - Street 1:2801 SLATER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8477
Mailing Address - Country:US
Mailing Address - Phone:919-990-8191
Mailing Address - Fax:919-237-7468
Practice Address - Street 1:2801 SLATER RD STE 200
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8477
Practice Address - Country:US
Practice Address - Phone:919-990-8191
Practice Address - Fax:919-237-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy