Healthcare Provider Details

I. General information

NPI: 1477554855
Provider Name (Legal Business Name): INTEGRATED CONCEPTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 ACADEMY PARKWAY S NE
ALBUQUERQUE NM
87109-4410
US

IV. Provider business mailing address

3807 ACADEMY PARKWAY S NE
ALBUQUERQUE NM
87109-4410
US

V. Phone/Fax

Practice location:
  • Phone: 505-345-9299
  • Fax: 505-345-9902
Mailing address:
  • Phone: 505-345-9299
  • Fax: 505-345-9902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH1832
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ROSS HUNTINGFORD
Title or Position: PRESIDENT
Credential:
Phone: 505-345-9299