Provider Demographics
NPI:1386253490
Name:AIMSMEDTX LLC
Entity type:Organization
Organization Name:AIMSMEDTX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOSSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-804-9007
Mailing Address - Street 1:111 E 3RD ST PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46546-0768
Mailing Address - Country:US
Mailing Address - Phone:574-804-9007
Mailing Address - Fax:
Practice Address - Street 1:1045 GEMINI ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2805
Practice Address - Country:US
Practice Address - Phone:574-804-9007
Practice Address - Fax:574-747-8652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty