NPIMap

Pharmaca Integrative Pharmacy, Inc.

Organization Active NPI Community/Retail Pharmacy · Redmond, WA

NPI 1013069822 · NPPES record last updated Apr 19, 2022

Key facts

NPI
1013069822
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
CF00000469 (WA)
Legal business name
PHARMACA INTEGRATIVE PHARMACY, INC.
Practice address
15840 Redmond Way
Redmond, WA 98052
Phone
(425) 885-2323
Fax
(425) 867-8988
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
Alison Farrell
Title
SVP Pharmacy Services
Phone
(717) 254-9011

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111026000113 WA Part B Supplier - Mass Immunization (Roster Biller Only) 1658550561 3 other NPIs on this enrollment
Practice locations: Redmond, WA; Seattle, WA

National Provider Directory

Locations

9101 W Olympic Blvd
Beverly Hills, CA 90212
Phone (310) 277-6266

6985 El Camino Real
Ste A103
Carlsbad, CA 92009
Phone (760) 444-3800

7650 Girard Ave
Ste 100
La Jolla, CA 92037
Phone (858) 454-1361

26538 Moulton Pkwy
#G
Laguna Hills, CA 92653
Phone (949) 900-1610

230 E Blithedale Ave
Mill Valley, CA 94941
Phone (231) 580-9179

7514 Redwood Blvd
Ste 104
Novato, CA 94945
Phone (415) 892-3700

925 Cole St
San Francisco, CA 94117
Phone (415) 661-3003

734 Montana Ave
Santa Monica, CA 90403
Phone (310) 451-1414

4940 Pearl East Cir
Ste 301
Boulder, CO 80301

5910 S University Blvd
Ste E2
Greenwood Village, CO 80121
Phone (303) 798-0388

2313 N Lincoln Ave
Chicago, IL 60614
Phone (773) 360-8595

8910 Holly Ave NE
Albuquerque, NM 87122
Phone (505) 796-0387

13 NW 23rd Pl
#3
Portland, OR 97210
Phone (503) 226-6211

240 NW Lost Springs Ter
#38
Portland, OR 97229
Phone (503) 596-3565

15840 Redmond Way
Redmond, WA 98052
Phone (425) 885-2323

4707 California Ave SW
#23
Seattle, WA 98116
Phone (206) 932-4225

4707 California Ave SW
Seattle, WA 98116
Phone (206) 932-4225

1815 N 45th St
Ste 110
Seattle, WA 98103
Phone (206) 385-6552

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00000469 WA Yes

Addresses

Primary practice location

15840 Redmond Way
Redmond, WA 98052

Mailing address

7088 Winchester Cir Ste 100
Boulder, CO 80301-3760
Phone (303) 442-2304

Other identifiers

IdentifierTypeStateIssuer
6043806MedicaidWA

Other names

  • Medly Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2022.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1013069822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7088 WINCHESTER CIR STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013760",
            "telephone_number": "303-442-2304",
            "fax_number": "303-867-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15840 REDMOND WAY",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "98052",
            "telephone_number": "425-885-2323",
            "fax_number": "425-867-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACA INTEGRATIVE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "SVP PHARMACY SERVICES",
        "authorized_official_telephone_number": "717-254-9011"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00000469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6043806",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medly Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

All providers in Redmond, WA · Community/Retail Pharmacy in Washington

Sources for this page

Verify at the official NPI Registry.