Healthcare Provider Details

I. General information

NPI: 1497818785
Provider Name (Legal Business Name): PHARMACA INTEGRATIVE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E BLITHEDALE AVE
MILL VALLEY CA
94941
US

IV. Provider business mailing address

7088 WINCHESTER CIR STE 100
BOULDER CO
80301-3760
US

V. Phone/Fax

Practice location:
  • Phone: 415-388-6354
  • Fax: 415-388-0326
Mailing address:
  • Phone: 303-442-2304
  • Fax: 303-867-4181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALISON FARRELL
Title or Position: SVP PHARMACY SERVICES
Credential:
Phone: 717-254-9011