Basic Information
| Provider Information | |||||||||
| NPI: | 1629411046 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IMS URGENT CARE DBA INTERGRATED MEDICAL SERVICES, INC. | ||||||||
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| OtherOrganizationName: | INTEGRATED MEDICAL SERVICES, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9250 N 3RD ST STE 4010 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850202432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026333838 | ||||||||
| FaxNumber: | 6026333850 | ||||||||
| Practice Location | |||||||||
| Address1: | 3540 E BASELINE RD | ||||||||
| Address2: | 131 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850429627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232517559 | ||||||||
| FaxNumber: | 4806217043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2013 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | DOVER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6028243370 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | AZ | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.