NPIMap

Organization Active NPI

Integral Pharmacy, LLC

  • Long Term Care Pharmacy
  • Gallup, NM
National Provider Identifier
1558859710
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH00004616 Issued in NM
Legal business name
INTEGRAL PHARMACY, LLC
Practice address
109 S Second St
Gallup, NM 87301-6219
Phone
(505) 862-9082
Fax
(844) 492-1938
NPI assigned
Apr 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Authorized official

Name
Stephanie Michelle Rodriguez, PHARM.DNPI 1215115571
Title
Pharmacist
Phone
(505) 862-9082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PH00004616 NM Primary

Addresses

Primary practice location

109 S Second St
Gallup, NM 87301-6219

Mailing address

224 Crestwood CT
Gallup, NM 87301-7120
Phone (505) 235-2810

National Provider Directory

National Provider Directory

Locations

109 S Second St
Gallup, NM 87301
Phone (505) 862-9082

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1558859710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CRESTWOOD CT",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873017120",
            "telephone_number": "505-235-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S SECOND ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016219",
            "telephone_number": "505-862-9082",
            "fax_number": "844-492-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "505-862-9082",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NM",
            "license": "PH00004616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.