MEDICARE: INTEGRITY MEDICAL SUPPLY

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

General Provider Information

NPI Number	:	1932619996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	307 N FREDERICK ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-5627
Country	:	US
Telephone Number	:	573-381-0410
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 N FREDERICK ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-5627
Country	:	US
Telephone Number	:	573-381-0410
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. JACKSON PRESTON SIPLES III
Credential	:
Telephone Number	:	573-381-0410

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	10/04/2017

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Directions to “INTEGRITY MEDICAL SUPPLY ” Practice Location

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