Provider Demographics
NPI:1588824742
Name:INTEGRATED MEDICAL RESOURCES, LLC
Entity Type:Organization
Organization Name:INTEGRATED MEDICAL RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-689-2300
Mailing Address - Street 1:7447 E BERRY AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2142
Mailing Address - Country:US
Mailing Address - Phone:303-689-2300
Mailing Address - Fax:303-689-2301
Practice Address - Street 1:7447 E BERRY AVE STE 150
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2142
Practice Address - Country:US
Practice Address - Phone:303-689-2300
Practice Address - Fax:303-689-2301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENVER PAIN MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty