Provider Demographics
NPI:1285927210
Name:IMED SOLUTIONS LLC
Entity type:Organization
Organization Name:IMED SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUNUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-570-6111
Mailing Address - Street 1:2142 ONEAL LN
Mailing Address - Street 2:#351
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3205
Mailing Address - Country:US
Mailing Address - Phone:225-925-9375
Mailing Address - Fax:225-925-9378
Practice Address - Street 1:4242 HIGHWAY 19 BLDG 3
Practice Address - Street 2:STE B
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-3910
Practice Address - Country:US
Practice Address - Phone:225-570-6111
Practice Address - Fax:225-709-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DT84Medicare PIN