Healthcare Provider Details

I. General information

NPI: 1033190210
Provider Name (Legal Business Name): INTEGRITY CLINICAL SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 WYOMING BLVD NE SUITE A
ALBUQUERQUE NM
87112-3866
US

IV. Provider business mailing address

1510 WYOMING BLVD NE SUITE A
ALBUQUERQUE NM
87112-3866
US

V. Phone/Fax

Practice location:
  • Phone: 505-293-1200
  • Fax: 505-332-1268
Mailing address:
  • Phone: 505-293-1200
  • Fax: 505-332-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT B MILLER
Title or Position: PRESIDENT
Credential: RRT
Phone: 505-293-1200