Organization Active NPI

Integrated Medication Management LLC

Doing business as HomeFree Pharmacy Services

  • Long Term Care Pharmacy
  • Mount Laurel, NJ
National Provider Identifier
1588194922
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
INTEGRATED MEDICATION MANAGEMENT LLC
Doing business as
HomeFree Pharmacy Services
Practice address
136 Gaither Dr Ste 120
Mount Laurel, NJ 08054-1725
Phone
(856) 380-1828
NPI assigned
Jun 18, 2017
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Kevin Matthew WilliamsNPI 1730496951
Title
Director of Pharmacy
Phone
(856) 380-1828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

136 Gaither Dr Ste 120
Mount Laurel, NJ 08054-1725

Mailing address

136 Gaither Dr Ste 120
Mount Laurel, NJ 08054-1725
Phone (856) 380-1828

Other names 1

  • HomeFree Pharmacy Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210910001996 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 5890191126 Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory
Tax ID family
Bayada Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

101 Executive Dr
Ste 10
Moorestown, NJ 08057

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": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1588194922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 GAITHER DR STE 120",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541725",
            "telephone_number": "856-380-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 GAITHER DR STE 120",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541725",
            "telephone_number": "856-380-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICATION MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "856-380-1828"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeFree Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.