Provider Demographics
NPI:1477554855
Name:INTEGRATED CONCEPTS
Entity Type:Organization
Organization Name:INTEGRATED CONCEPTS
Other - Org Name:PHARMACARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTINGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-345-9299
Mailing Address - Street 1:3807 ACADEMY PARKWAY S NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4410
Mailing Address - Country:US
Mailing Address - Phone:505-345-9299
Mailing Address - Fax:505-345-9902
Practice Address - Street 1:3807 ACADEMY PARKWAY S NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4410
Practice Address - Country:US
Practice Address - Phone:505-345-9299
Practice Address - Fax:505-345-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NMPH1832333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NML7182Medicaid
NM61447Medicaid