Provider Demographics
NPI:1750523916
Name:INTEGRATIVE HOMEOPATHY, P.L.L.C.
Entity type:Organization
Organization Name:INTEGRATIVE HOMEOPATHY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MD(H)
Authorized Official - Phone:602-326-7471
Mailing Address - Street 1:2001 W CAMELBACK RD
Mailing Address - Street 2:AMERICAN MEDICAL COLLEGE OF HOMEOPATHY
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3466
Mailing Address - Country:US
Mailing Address - Phone:602-347-7950
Mailing Address - Fax:
Practice Address - Street 1:2001 W CAMELBACK RD
Practice Address - Street 2:AMERICAN MEDICAL COLLEGE OF HOMEOPATHY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3466
Practice Address - Country:US
Practice Address - Phone:602-347-7950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM20040743261QM2500X
MI4301028720261QM2500X
AZ13927261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1174516207OtherNPI TYPE 1
AZZ60343Medicare PIN