MEDICARE: INTEGRATED NURSING ASSOCIATES, LLC

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	251J00000X	Nursing Care Agency	HP0047300	NJ

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

General Provider Information

NPI Number	:	1972720738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED NURSING ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	2999 N 44TH ST STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7247
Country	:	US
Telephone Number	:	480-618-5760
Fax Number	:	602-253-5656

Provider Business Practice Location Address
First Line	:	32 N BEVERWYCK RD
Second Line	:	SUITE #6
City	:	LAKE HIAWATHA
State	:	NJ
Zip	:	07034-2512
Country	:	US
Telephone Number	:	973-331-1901
Fax Number	:	973-331-1907

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIKE LOVELL
Credential	:
Telephone Number	:	480-618-5760

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	02/02/2022

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