Healthcare Provider Details
I. General information
NPI: 1306022785
Provider Name (Legal Business Name): INTEGRITY MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2008
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 CLYBORN ST
DOWAGIAC MI
49047-1504
US
IV. Provider business mailing address
205 CLYBORN ST
DOWAGIAC MI
49047-1504
US
V. Phone/Fax
- Phone: 269-782-4362
- Fax:
- Phone: 269-782-4362
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
DUNCAN
JR.
Title or Position: PRESIDENT
Credential:
Phone: 269-782-4362