Healthcare Provider Details

I. General information

NPI: 1609691039
Provider Name (Legal Business Name): INTERGRATED PHARMACEUTICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1478 N WILSON AVE
BARTOW FL
33830-3373
US

IV. Provider business mailing address

PO BOX 46216
TAMPA FL
33646-0102
US

V. Phone/Fax

Practice location:
  • Phone: 863-537-6694
  • Fax: 863-537-6579
Mailing address:
  • Phone: 863-537-6694
  • Fax: 863-537-6579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ENOCH A OFOSU
Title or Position: PHARMACY MGR
Credential: MD, PHARM.D
Phone: 863-537-6694