Healthcare Provider Details

I. General information

NPI: 1205584059
Provider Name (Legal Business Name): INTEGRATED PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7304 ALMA DR STE 200
PLANO TX
75025-3563
US

IV. Provider business mailing address

7815 N PALM AVE STE 400
FRESNO CA
93711-5531
US

V. Phone/Fax

Practice location:
  • Phone: 855-341-1449
  • Fax:
Mailing address:
  • Phone: 559-476-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HAWKINS
Title or Position: CHIEF STRATEGY OFFICER
Credential: CPHT
Phone: 817-600-6413