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General NPI Number Information
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NPI Number | 1992846901
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Entity Type | Organization
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Legal Business Name | INTEGRATED CONCEPTS, INC.
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 915 FARMINGTON AVE SUITE E-1
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City | FARMINGTON
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State | NM
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Zip | 87401-7475
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Country | US
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Telephone | 505-564-9933
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Fax | 505-564-9955
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Provider Business Mailing Address
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Address Line | 915 FARMINGTON AVE SUITE E-1
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City | FARMINGTON
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State | NM
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Zip | 87401-7475
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Country | US
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Telephone | 505-564-9933
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Fax | 505-564-9955
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Authorized Official
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Title or Position | VP
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Name | TERRY L. HUNTINGFORD
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Credential |
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Telephone | 505-345-9299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 07-00004231
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License Number State | NM
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