Provider Demographics
NPI:1629411046
Name:IMS URGENT CARE DBA INTERGRATED MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:IMS URGENT CARE DBA INTERGRATED 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 1:9250 N 3RD ST STE 4010
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2432
Mailing Address - Country:US
Mailing Address - Phone:602-633-3838
Mailing Address - Fax:602-633-3850
Practice Address - Street 1:3540 E BASELINE RD
Practice Address - Street 2:131
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-9627
Practice Address - Country:US
Practice Address - Phone:623-251-7559
Practice Address - Fax:480-621-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care