Organization Active NPI

TLC Integrative Pharmacy Inc

  • Community/Retail Pharmacy
  • Bellevue, WA
National Provider Identifier
1174699284
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00058793 Issued in WA
Legal business name
TLC INTEGRATIVE PHARMACY INC
Practice address
15600 NE 8TH St
Ste K8
Bellevue, WA 98008-3927
Phone
(425) 653-2323
Fax
(425) 653-3535
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Dmitry Lefelman, RPH
Title
Owner Pic
Phone
(425) 785-4955

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00058793 WA Primary
Compounding Pharmacy 3336C0004X
Managed Care Organization Pharmacy 3336M0003X

Addresses

Primary practice location

15600 NE 8TH St
Ste K8
Bellevue, WA 98008-3927

Mailing address

15600 NE 8TH St
Ste K8
Bellevue, WA 98008-3927
Phone (425) 653-2323

Other identifiers 1

IdentifierTypeStateIssuer
4932162OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • TLC INTEGRATIVE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

15600 NE 8th St
Ste K8
Bellevue, WA 98008
Phone (425) 653-2323

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1174699284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 NE 8TH ST",
            "address_2": "STE K8",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083927",
            "telephone_number": "425-653-2323",
            "fax_number": "425-653-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NE 8TH ST",
            "address_2": "STE K8",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083927",
            "telephone_number": "425-653-2323",
            "fax_number": "425-653-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC INTEGRATIVE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "LEFELMAN",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "OWNER PIC",
        "authorized_official_telephone_number": "425-785-4955",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00058793",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4932162",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLC INTEGRATIVE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.