Provider Demographics
NPI:1417286709
Name:1ST CARE URGENT CARE DBA INTEGRATED MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:1ST CARE URGENT CARE DBA INTEGRATED MEDICAL SERVICES, INC.
Other - Org Name:INTEGRATED MEDICAL SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-824-3370
Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3838
Mailing Address - Fax:602-633-3850
Practice Address - Street 1:1300 S WATSON RD STE A-104
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-6303
Practice Address - Country:US
Practice Address - Phone:623-251-3201
Practice Address - Fax:623-251-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ326831Medicaid