Provider Demographics
NPI:1518626704
Name:IMPRUVON INC.
Entity type:Organization
Organization Name:IMPRUVON INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-818-7272
Mailing Address - Street 1:10900 UNIVERSITY BOULEVARD
Mailing Address - Street 2:KATHERINE G. JOHNSON HALL, SUITE 147
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:410-818-7272
Mailing Address - Fax:
Practice Address - Street 1:2101 E BIDDLE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-3307
Practice Address - Country:US
Practice Address - Phone:410-818-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies