MEDICARE: INTEGRATED MEDICAL 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	332B00000X	Durable Medical Equipment & Medical Supplies	18471226	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295739928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED MEDICAL INC

Provider Business Mailing Address
First Line	:	15627 NEO PKWY
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-3150
Country	:	US
Telephone Number	:	216-332-1550
Fax Number	:	216-332-1555

Provider Business Practice Location Address
First Line	:	15627 NEO PKWY
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-3150
Country	:	US
Telephone Number	:	216-332-1550
Fax Number	:	216-332-1555

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. JENNIFER L SYLVESTER
Credential	:
Telephone Number	:	216-332-1550

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/08/2010

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Directions to “INTEGRATED MEDICAL INC ” Practice Location

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