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General NPI Number Information
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NPI Number | 1285095497
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Entity Type | Organization
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Legal Business Name | INTEGRATED PHARMACY, LLC
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 516 DENVER ST SUITE 200
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City | WICHITA FALLS
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State | TX
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Zip | 76301-2110
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Country | US
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Telephone | 866-499-1138
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Fax |
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Provider Business Mailing Address
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Address Line | 7815 N PALM AVE SUITE 400
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City | FRESNO
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State | CA
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Zip | 93711-5530
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Country | US
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Telephone | 559-476-8000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | KURT BELLUOMINI
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Credential |
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Telephone | 559-476-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 30707
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 30707
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License Number State | TX
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