Provider Demographics
NPI:1467752287
Name:ADVANCED INTEGRATED MEDICATIONS
Entity Type:Organization
Organization Name:ADVANCED INTEGRATED MEDICATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:GOPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-236-2977
Mailing Address - Street 1:11500 N STEMMONS FWY
Mailing Address - Street 2:SUITE 158
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:469-464-1235
Practice Address - Street 1:11500 N STEMMONS FWY
Practice Address - Street 2:SUITE 158
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2184
Practice Address - Country:US
Practice Address - Phone:469-619-3005
Practice Address - Fax:469-464-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy