Healthcare Provider Details

I. General information

NPI: 1851723522
Provider Name (Legal Business Name): INTEGRATED CARE PHARMACIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 MARKET STREET STE J
CRAMERTON NC
28032-1151
US

IV. Provider business mailing address

741 5TH ST. SW
HICKORY NC
28602
US

V. Phone/Fax

Practice location:
  • Phone: 704-879-4010
  • Fax: 704-879-4020
Mailing address:
  • Phone: 828-322-5915
  • Fax: 828-345-0387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number12144
License Number StateNC

VIII. Authorized Official

Name: DR. COREY RICHARDSON
Title or Position: OWNER / CEO
Credential:
Phone: 828-322-5915