MEDICARE: INTEGRITY ONCOLOGY FOUNDATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1184909384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY ONCOLOGY FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1000 DEPT 0170
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148-0170
Country	:	US
Telephone Number	:	901-853-6012
Fax Number	:	901-854-7630

Provider Business Practice Location Address
First Line	:	1936 W POPLAR AVE
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-0605
Country	:	US
Telephone Number	:	901-853-6012
Fax Number	:	901-854-7630

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ROLA OBAJI
Credential	:
Telephone Number	:	901-853-6012

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/24/2012

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