NPIMap

Organization Active NPI

Pharmaca Integrative Pharmacy

  • Community/Retail Pharmacy
  • San Diego, CA
National Provider Identifier
1497918221
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 49112 Issued in CA
Legal business name
PHARMACA INTEGRATIVE PHARMACY
Practice address
8650 Genesee Ave
Ste 100
San Diego, CA 92122-1134
Phone
(858) 362-5359
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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 PHY 49112 CA Primary

Addresses

Primary practice location

8650 Genesee Ave
Ste 100
San Diego, CA 92122-1134

Mailing address

4940 Pearl East Cir
Suite 301
Boulder, CO 80301-2489
Phone (303) 442-2304

Other identifiers 1

IdentifierTypeStateIssuer
5630834OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • PHARMACA INTEGRATIVE PHARMACY Doing business as

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

8650 Genesee Ave
Ste 100
San Diego, CA 92122
Phone (858) 362-5359

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1497918221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 PEARL EAST CIR",
            "address_2": "SUITE 301",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012489",
            "telephone_number": "303-442-2304",
            "fax_number": "303-442-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 GENESEE AVE",
            "address_2": "STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221134",
            "telephone_number": "858-362-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACA INTEGRATIVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2017-07-21",
        "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": "PHY 49112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5630834",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMACA INTEGRATIVE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.