IMPAKT MEDICAL, LLC (NPI# 1992299838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992299838 |
| Entity Type | Organization |
| Organization Name | IMPAKT MEDICAL, LLC |
| Other Organization Name | IMPAKT MEDICAL, LLC |
| Practice Address |
9722 Fair Oaks Blvd Ste B Fair Oaks CA 95628-7039 |
| Practice Telephone | 9168447800 |
| Practice Fax Number | 8332278034 |
| Mailing Telephone | 9168447800 |
| Mailing Fax Number | 8332278034 |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |
| Authorized Official Name | BRYANT MAJERNIK (OWNER / VICE PRESIDENT) |
| Authorized Official Telephone | 9168447800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
99174 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Impakt Medical, LLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143479 | Impakt Medical, LLC | Durable Medical Equipment & Medical Supplies | 14125 Capri Dr Ste 8, Los Gatos, CA 95032-1516 | 2020-10-28 |
| 1417429648 | Impakt Medical, LLC | Durable Medical Equipment & Medical Supplies | 700 Frederick St Ste 301, Santa Cruz, CA 95062-2239 | 2018-12-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | IMPAKT MEDICAL, LLC | 9722 Fair Oaks Blvd Ste B, Fair Oaks, CA 95628-7039 |
| Street Address |
9722 FAIR OAKS BLVD STE B |
| City | FAIR OAKS |
| State | CA |
| Zip Code | 95628-7039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103590 | Nora's Home Care, Inc | Assisted Living Facility | 5813 Kenneth Ave, Fair Oaks, CA 95628 | 2018-08-08 |
| 1124545512 | Shelby Matthews | Behavior Technician | 7712 Magnolia Ave, Fair Oaks, CA 95628 | 2017-08-25 |
| 1386166908 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. B, Fair Oaks, CA 95628 | 2017-07-14 |
| 1063934867 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. A, Fair Oaks, CA 95628 | 2017-07-13 |
| 1467986075 | Shelby Bryeans | Behavior Technician | 7949 California Ave Ste 15, Fair Oaks, CA 95628 | 2017-04-20 |
| 1942698790 | Life Span Home, Inc | Home Health | 4041 Bridge Street, Fair Oaks, CA 95628 | 2015-01-02 |
| 1861808008 | Edward John Olson | Social Worker | 5213 Vista Del Oro Way, Fair Oaks, CA 95628 | 2014-07-09 |
| 1073924643 | Frank Gontarski | Dentist | 4363 Hazel Avenue, Suite 6, Fair Oaks, CA 95628 | 2014-05-16 |
| 1801232921 | Lisa Hitomi | Community Health Worker | 9915 Fair Oaks Blvd, Fair Oaks, CA 95628 | 2013-05-15 |
| 1972842375 | Nicole Diana Cable | Marriage & Family Therapist | 10217 Fair Oaks Blvd, Suite A, Fair Oaks, CA 95628 | 2013-02-05 |
| Find all providers in zip 95628 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124176359 | Family Home Medical Inc | Durable Medical Equipment & Medical Supplies | 5525 Dewey Drive, Suite 106a, Fair Oaks, CA 95628-3130 | 2007-01-05 |
| 1194809871 | Abacus Medical Equipment Supply, Inc. | Durable Medical Equipment & Medical Supplies | 8510 Madison Ave, Suite D, Fair Oaks, CA 95628-3809 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967259 | Tarlani Corp. | Durable Medical Equipment & Medical Supplies | 315 Arden Ave Ste 4, Glendale, CA 91203-1165 | 2020-09-17 |
| 1649803545 | Martha Ortega | Durable Medical Equipment & Medical Supplies | 3888 Sage Hill Pl, Santa Rosa, CA 95404-7696 | 2020-02-19 |
| 1568094001 | Bans Healthcare Group, Inc. | Durable Medical Equipment & Medical Supplies | 31133 Via Colinas Ste 103, Westlake Village, CA 91362-4519 | 2020-02-11 |
| 1992343867 | Oxygen Services Southwest LLC | Durable Medical Equipment & Medical Supplies | 13396 Contour Dr, Sherman Oaks, CA 91423-4802 | 2019-12-11 |
| 1538702568 | Can-al Medical Supplies | Durable Medical Equipment & Medical Supplies | 6650 Fair Oaks Blvd, Carmichael, CA 95608-4026 | 2019-10-22 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326607011 | Herocare LLC | Durable Medical Equipment & Medical Supplies | 12598 Central Ave Ste 109, Chino, CA 91710-3500 | 2019-06-06 |
| 1205300050 | Expedite LLC | Durable Medical Equipment & Medical Supplies | 8910 University Center Ln Ste 400, San Diego, CA 92122-1025 | 2019-01-15 |
| 1073093746 | Sgr Medical Solutions L.L.C. | Durable Medical Equipment & Medical Supplies | 2717 Cabernet Way, Rancho Cordova, CA 95670-4811 | 2018-08-21 |
| 1134607120 | Pulmonic Health, LLC | Durable Medical Equipment & Medical Supplies | 402 W Bedford Ave Ste 103, Fresno, CA 93711-6884 | 2018-08-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.