MEDICARE: INTEGRITY PHARMACY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy	PH22867	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1028035	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1942493929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY PHARMACY SERVICES LLC

Provider Business Mailing Address
First Line	:	3802 CORPOREX PARK DR
Second Line	:	SUITE 200 BILLING & COLLECT
City	:	TAMPA
State	:	FL
Zip	:	33619-1125
Country	:	US
Telephone Number	:	813-318-6242
Fax Number	:	813-318-6725

Provider Business Practice Location Address
First Line	:	6435 HAZELTINE NATIONAL DR
Second Line	:	STE 140
City	:	ORLANDO
State	:	FL
Zip	:	32822-5158
Country	:	US
Telephone Number	:	321-281-3111
Fax Number	:	407-816-3171

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	THOMAS CANERIS
Credential	:
Telephone Number	:	502-627-7100

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	09/21/2010

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