Organization
INTEGRATED CARE SYSTEMS INC
Active
Other names
Integrated Care Systems
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN K KOMOTO (PRESIDENT)
(559) 734-2896
Entity
Organization
Contact information
Practice address
7140 W. PERSHING CT., VISALIA, CA 93291
(559) 734-2896
(559) 734-6451
Mailing address
7140 W. PERSHING CT., VISALIA, CA 93291
(559) 734-2896
(559) 734-6451
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
PHY47381
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PHY45751
CA
3336H0001X
Home Infusion Therapy Pharmacy
PHY47381
CA
3336S0011X
Specialty Pharmacy
PHY47381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521496
NABP NUMBER
CA
05
—
1255330403
—
CA
05
—
PHA457510
—
CA
01
—
PHY47381
PHARMACY PERMIT
CA
Enumeration date
07/19/2005
Last updated
03/27/2017
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