Active NPI
Pharmaca Integrative Pharmacy, Inc.
- Community/Retail Pharmacy
- Boulder, CO
National Provider Identifier
1235150285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 90000004
- Legal business name
- PHARMACA INTEGRATIVE PHARMACY, INC.
- Practice address
- 1647 Pearl Street
Boulder, CO 80302 - Phone
- (303) 442-5164
- Fax
- (303) 939-9388
- NPI assigned
- Jul 22, 2006
- Organization subpart
- Yes
- Parent organization
- PHARMACA INTEGRATIVE PHARMACY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Greg Legore
- Title
- Director of Pharmacy Operations
- Phone
- (805) 217-9926
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 90000004 | CO | Primary |
Addresses
Primary practice location
1647 Pearl Street
Boulder, CO 80302
Mailing address
4940 Pearl East Circle
Suite 301
Boulder, CO 80301-2489
Phone (303) 867-3182
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0601787 | Other | OTHER ID NUMBER | |
| 58322272 | Medicaid | CO | |
| 58-322272 | Medicaid | CO | |
| 0601787 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
National Provider Directory
National Provider Directory- Part of
- Pharmaca Integrative Pharmacy
Locations
1647 Pearl St
Boulder, CO 80302
Phone (303) 442-5164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1533254400000",
"number": "1235150285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4940 PEARL EAST CIRCLE",
"address_2": "SUITE 301",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012489",
"telephone_number": "303-867-3182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1647 PEARL STREET",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "303-442-5164",
"fax_number": "303-939-9388"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARMACA INTEGRATIVE PHARMACY, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PHARMACA INTEGRATIVE PHARMACY",
"enumeration_date": "2006-07-22",
"last_updated": "2018-08-03",
"status": "A",
"authorized_official_last_name": "LEGORE",
"authorized_official_first_name": "GREG",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY OPERATIONS",
"authorized_official_telephone_number": "805-217-9926"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CO",
"license": "90000004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER",
"identifier": "0601787",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58322272",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58-322272",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0601787",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.