Organization
ICP HOLDINGS, LLC
Active
Other names
Integrity Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY GAETANO (MANAGING PARTNER)
(404) 814-1610
Entity
Organization
Contact information
Practice address
8601 DUNWOODY PL STE 750, SANDY SPRINGS, GA 30350-2519
(404) 815-1610
(404) 815-1609
Mailing address
8601 DUNWOODY PL STE 750, SANDY SPRINGS, GA 30350-2519
(404) 815-1610
(404) 815-1609
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165814
PK
—
Enumeration date
10/20/2016
Last updated
01/09/2019
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