Healthcare Provider Details
I. General information
NPI: 1508184276
Provider Name (Legal Business Name): INTEGRITY MEDICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6770 N 9TH AVE
PENSACOLA FL
32504-7346
US
IV. Provider business mailing address
1 ALPHA AVE SUITE 20
VOORHEES NJ
08043-1049
US
V. Phone/Fax
- Phone: 850-478-9660
- Fax:
- Phone: 856-616-2393
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NANCY
LUKE
Title or Position: CFO
Credential:
Phone: 856-616-2393