Provider Demographics
NPI:1558444067
Name:INTEGRITY MEDICAL SUPPLIES, LLC
Entity type:Organization
Organization Name:INTEGRITY MEDICAL SUPPLIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:2100 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3809
Mailing Address - Country:US
Mailing Address - Phone:727-535-9801
Mailing Address - Fax:727-539-6452
Practice Address - Street 1:2100 TALL PINES DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3809
Practice Address - Country:US
Practice Address - Phone:727-535-9801
Practice Address - Fax:727-539-6452
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-20
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5248320001Medicare ID - Type UnspecifiedPROVIDER NUMBER
5248320001Medicare NSC