Integra Network Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24183 Issued in FL

Legal business name

INTEGRA NETWORK CORP

Doing business as

Integra Rx

Practice address

2661 W Atlantic Blvd
Pompano Beach, FL 33069-2507

Phone

(954) 917-6813

Fax

(954) 917-6814

NPI assigned

Jul 30, 2009

Last updated

Sep 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Antonio

Title

President

Phone

(954) 917-6813

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Integra Rx Doing business as

Tax ID family

Integra Network Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Integra Network Corp

  dba Integra Rx

  • Mail Order Pharmacy
  • Pompano Beach, FL
  • NPI 1629525530
  NPD tax ID

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.

• Lisa Crawford

  • Pharmacist
  • Pompano Beach, FL
  • NPI 1821229428
  NPD (past)

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1528299120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 W ATLANTIC BLVD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330692507",
            "telephone_number": "954-917-6813",
            "fax_number": "954-917-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 W ATLANTIC BLVD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330692507",
            "telephone_number": "954-917-6813",
            "fax_number": "954-917-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA NETWORK CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "ANTONIO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-917-6813"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001560800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121287",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integra Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Institute for Collegiate Sports Medicine
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• Integra Network Corp (Integra Rx)
• Integral Primary Care Inc.
• Integrated Dermatology of Pompano Beach LLC
• Integrated Medical Supply LLC
• Integrative Health Practice LLC

• Community/Retail Pharmacy in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.