Provider Demographics
NPI:1922443985
Name:INTEGRATED HEALTHCARE CO OP LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE CO OP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:F-NP
Authorized Official - Phone:615-693-9149
Mailing Address - Street 1:1915 1/2 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2203
Mailing Address - Country:US
Mailing Address - Phone:615-693-9149
Mailing Address - Fax:888-872-5109
Practice Address - Street 1:1915 1/2 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2203
Practice Address - Country:US
Practice Address - Phone:615-693-9149
Practice Address - Fax:888-872-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-05
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty