NPIMap

Organization Active NPI

Pharmaca Integrative Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Mill Valley, CA
National Provider Identifier
1497818785
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACA INTEGRATIVE PHARMACY, INC.
Practice address
230 E Blithedale Ave
Mill Valley, CA 94941
Phone
(415) 388-6354
Fax
(415) 388-0326
NPI assigned
Dec 18, 2006
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

230 E Blithedale Ave
Mill Valley, CA 94941

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
PHA46017MedicaidCA
0518083OtherOTHER ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908001894 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1658550561 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mill Valley, CA; Sonoma, CA; Santa Monica, CA; Pacific Palisades, CA; Oakland, CA; Novato, CA; Napa, CA; Monterey, CA…

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1497818785",
    "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": "230 E BLITHEDALE AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-388-6354",
            "fax_number": "415-388-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACA INTEGRATIVE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA46017",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0518083",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.