NPIMap

Organization Active NPI

Pharmaca Integrative Pharmacy

  • Community/Retail Pharmacy
  • Irvine, CA
National Provider Identifier
1144410382
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
48639 Issued in CA
Legal business name
PHARMACA INTEGRATIVE PHARMACY
Practice address
4139 Campus Dr
Irvine, CA 92612-2645
Phone
(949) 823-9762
Fax
(949) 823-9763
NPI assigned
Jul 25, 2007
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Kruteck
Title
Cfo
Phone
(303) 867-3163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 48639 CA Primary

Addresses

Primary practice location

4139 Campus Dr
Irvine, CA 92612-2645

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
5627661OtherOTHER ID NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Pharmaca Integrative Pharmacy9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4139 Campus Dr
Irvine, CA 92612
Phone (949) 823-9762

7088 Winchester Cir
Boulder, CO 80301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1144410382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7088 WINCHESTER CIR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013760",
            "telephone_number": "303-442-2304",
            "fax_number": "303-867-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 CAMPUS DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122645",
            "telephone_number": "949-823-9762",
            "fax_number": "949-823-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACA INTEGRATIVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "KRUTECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-867-3163"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "48639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5627661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.