Provider Demographics
NPI:1588132013
Name:IMPACT HEALTH BIOMETRIC TESTING, INC.
Entity type:Organization
Organization Name:IMPACT HEALTH BIOMETRIC TESTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-445-1892
Mailing Address - Street 1:1009 W 9TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1211
Mailing Address - Country:US
Mailing Address - Phone:610-962-9333
Mailing Address - Fax:610-337-4544
Practice Address - Street 1:1009 W 9TH AVE STE A
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1211
Practice Address - Country:US
Practice Address - Phone:610-962-9333
Practice Address - Fax:610-337-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory