Provider Demographics
NPI:1114359817
Name:INTEGRACARE PHARMACY INC.
Entity Type:Organization
Organization Name:INTEGRACARE PHARMACY INC.
Other - Org Name:INTEGRACARE PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-273-9002
Mailing Address - Street 1:199 CORPORATE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-4844
Mailing Address - Country:US
Mailing Address - Phone:205-406-0093
Mailing Address - Fax:888-583-4951
Practice Address - Street 1:199 CORPORATE WOODS DR
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-4844
Practice Address - Country:US
Practice Address - Phone:205-406-0093
Practice Address - Fax:888-583-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1130373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142575OtherPK