Provider Demographics
NPI:1457964355
Name:INTEGRATED RX OUTCOMES INC
Entity type:Organization
Organization Name:INTEGRATED RX OUTCOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-904-2529
Mailing Address - Street 1:447 LAKE VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1873
Mailing Address - Country:US
Mailing Address - Phone:734-904-2529
Mailing Address - Fax:
Practice Address - Street 1:447 LAKE VICTORIA CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-1873
Practice Address - Country:US
Practice Address - Phone:734-904-2529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization