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General NPI Number Information
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NPI Number | 1538404538
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CARE SERVICES, LLC
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Dates
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Enumeration Date | 12/01/2012
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Last Update Date | 12/01/2012
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Provider Practice Location Address
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Address Line | 417 SANCHO DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3888
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Country | US
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Telephone | 865-256-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 417 SANCHO DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3888
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | MELISSA ROBINSON
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Credential | PHARMD
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Telephone | 865-256-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RPH026848
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH026848
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License Number State | GA
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