Provider Demographics
NPI:1669247128
Name:INTEGRAL MEDICAL CARE LLC
Entity type:Organization
Organization Name:INTEGRAL MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-652-7554
Mailing Address - Street 1:8 RAINBOW TRL
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07422-1204
Mailing Address - Country:US
Mailing Address - Phone:862-368-7442
Mailing Address - Fax:
Practice Address - Street 1:8 RAINBOW TRL
Practice Address - Street 2:
Practice Address - City:HIGHLAND LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07422-1204
Practice Address - Country:US
Practice Address - Phone:862-368-7442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center