1649572223 NPI number — INTEGRATED MANAGEMENT SOLUTIONS, 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 1649572223 NPI number — INTEGRATED MANAGEMENT SOLUTIONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRATED MANAGEMENT SOLUTIONS, 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:
LIFETIME DESIGNS
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:
1649572223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITESBORO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76273-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-564-1898
Provider Business Mailing Address Fax Number:
903-564-4691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 N TRAVIS ST STE K
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75092-3773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-892-3222
Provider Business Practice Location Address Fax Number:
903-892-9444
Provider Enumeration Date:
12/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HICKMAN
Authorized Official First Name:
GREGG
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
903-564-1898

Provider Taxonomy Codes

  • Taxonomy code: 171WH0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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