1225140817 NPI number — INTEGRITY INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225140817 NPI number — INTEGRITY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRITY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DBA PHARMAX PHARMACY #1343
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225140817
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
113 SAINT FRANCOIS PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEADINGTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63601-4454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-431-5040
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 SAINT FRANCOIS PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEADINGTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63601-4454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-431-5040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCINTOSH
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
T
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
314-954-5510

Provider Taxonomy Codes

  • Taxonomy code: 163WD0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PS005737 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 600283626 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2606361 . This is a "NCPDP #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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