Provider Demographics
NPI:1528721974
Name:METABOLIC CODE ENTERPRISES, INC
Entity type:Organization
Organization Name:METABOLIC CODE ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAVALLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-608-7883
Mailing Address - Street 1:1271 IDA ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1525
Mailing Address - Country:US
Mailing Address - Phone:513-608-7883
Mailing Address - Fax:
Practice Address - Street 1:1271 IDA ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1525
Practice Address - Country:US
Practice Address - Phone:513-608-7883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Single Specialty