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General NPI Number Information
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NPI Number | 1225482474
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Entity Type | Organization
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Legal Business Name | INTEGRATED MEDICAL ENTERPRISES,INC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 2140 MCGEE RD SUITE C530
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City | SNELLVILLE
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State | GA
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Zip | 30078-2980
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Country | US
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Telephone | 770-940-9941
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Fax | 770-417-8263
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Provider Business Mailing Address
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Address Line | 947 ABBEY PARK WAY ABBEY PARK WAY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3377
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Country | US
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Telephone | 770-940-9941
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Fax | 770-417-8263
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PRISCILLA NGOZI MADU STERLING
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Credential | REGISTERED NURSE,BSN
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Telephone | 770-940-9941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN134161
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN134161
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License Number State | GA
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