Healthcare Provider Details

I. General information

NPI: 1255330403
Provider Name (Legal Business Name): INTEGRATED CARE SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 W. PERSHING CT.
VISALIA CA
93291
US

IV. Provider business mailing address

7140 W PERSHING CT
VISALIA CA
93291-7941
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-2896
  • Fax: 559-734-6451
Mailing address:
  • Phone: 559-734-2896
  • Fax: 559-734-6451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberPHY47381
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHY45751
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY47381
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY47381
License Number StateCA

VIII. Authorized Official

Name: AMANDA LYNN BURAND
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 262-510-7740