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General NPI Number Information
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NPI Number | 1255330403
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Entity Type | Organization
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Legal Business Name | INTEGRATED CARE SYSTEMS INC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 7140 W. PERSHING CT.
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City | VISALIA
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State | CA
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Zip | 93291
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Country | US
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Telephone | 559-734-2896
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Fax | 559-734-6451
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Provider Business Mailing Address
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Address Line | 7140 W. PERSHING CT.
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City | VISALIA
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State | CA
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Zip | 93291
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Country | US
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Telephone | 559-734-2896
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Fax | 559-734-6451
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN K KOMOTO
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Credential |
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Telephone | 559-734-2896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHY47381
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | PHY47381
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PHY47381
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | PHY45751
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License Number State | CA
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