NPIMap

Organization Active NPI

Pharmaca Intergrative Pharmacy

  • Community/Retail Pharmacy
  • Boulder, CO
National Provider Identifier
1588728356
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACA INTERGRATIVE PHARMACY
Practice address
1647 Pearl St
Boulder, CO 80302-5410
Phone
(303) 442-5164
NPI assigned
Dec 19, 2006
Last updated
May 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Authorized official

Name
Greg Legore
Title
Ceo
Phone
(805) 217-9926

Specialties & licenses 1

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

Addresses

Primary practice location

1647 Pearl St
Boulder, CO 80302-5410

Mailing address

4940 Pearl East Cir Ste 301
Boulder, CO 80301-2442
Phone (303) 867-3181

Other identifiers 1

IdentifierTypeStateIssuer
58-322272MedicaidCO

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1588728356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 PEARL EAST CIR STE 301",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012442",
            "telephone_number": "303-867-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025410",
            "telephone_number": "303-442-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACA INTERGRATIVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "LEGORE",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-217-9926"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58-322272",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.