Provider Demographics
NPI:1073758868
Name:INTEGRATED HEALTH CONCEPTS, LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HOLLIES
Authorized Official - Last Name:SCHRENKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-573-9873
Mailing Address - Street 1:DEPT 888242
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8242
Mailing Address - Country:US
Mailing Address - Phone:423-573-9873
Mailing Address - Fax:423-573-9875
Practice Address - Street 1:28 MIDWAY ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1706
Practice Address - Country:US
Practice Address - Phone:423-573-9873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA51348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAGC1164Medicare PIN