Provider Demographics
NPI:1770596306
Name:INTEGRATED MEDICAL SERVICES PLC
Entity type:Organization
Organization Name:INTEGRATED MEDICAL SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LESKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-474-7460
Mailing Address - Street 1:1446 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7300
Mailing Address - Country:US
Mailing Address - Phone:757-474-7460
Mailing Address - Fax:757-474-7455
Practice Address - Street 1:1450 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7302
Practice Address - Country:US
Practice Address - Phone:757-474-7470
Practice Address - Fax:757-474-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC790185LMedicaid
VAC05889Medicare ID - Type UnspecifiedGROUP NUMBER
VAC06963Medicare ID - Type UnspecifiedGROUP NUMBER
VAC06045Medicare ID - Type UnspecifiedGROUP NUMBER
VAG75678Medicare ID - Type UnspecifiedGROUP NUMBER
NC790185LMedicaid