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General NPI Number Information
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NPI Number | 1316465859
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1284 GLANDOR CT SE
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City | MABLETON
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State | GA
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Zip | 30126-2755
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Country | US
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Telephone | 678-576-4708
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Fax |
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Provider Business Mailing Address
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Address Line | 1284 GLANDOR CT SE
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City | MABLETON
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State | GA
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Zip | 30126-2755
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Country | US
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Telephone | 678-576-4708
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Fax |
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Authorized Official
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Title or Position | PHARMACIST CONSULTANT/ DIRECTOR
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Name | DR. CHIBUGO EJISOBY-NWOSU
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Credential | PHARMD
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Telephone | 678-576-4708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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