Healthcare Provider Details

I. General information

NPI: 1598680688
Provider Name (Legal Business Name): NTEGROUS CORE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E FOOTHILL BLVD STE 205
PASADENA CA
91107-7106
US

IV. Provider business mailing address

2700 E FOOTHILL BLVD STE 205
PASADENA CA
91107-7106
US

V. Phone/Fax

Practice location:
  • Phone: 626-398-1696
  • Fax: 626-398-9860
Mailing address:
  • Phone: 626-398-1696
  • Fax: 626-398-9860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARVA ANDERSON BRANNUM
Title or Position: CEO/CFO/SEC./DIR.
Credential:
Phone: 626-398-1696