Provider Demographics
NPI:1982881249
Name:INTEGRITY PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:INTEGRITY PHARMACY SERVICES, LLC
Other - Org Name:INTEGRITY PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-627-7100
Mailing Address - Street 1:489 SHOEMAKER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4235
Mailing Address - Country:US
Mailing Address - Phone:484-889-1489
Mailing Address - Fax:
Practice Address - Street 1:489 SHOEMAKER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4235
Practice Address - Country:US
Practice Address - Phone:484-889-1489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-29
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4817743336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020922380001Medicaid