Provider Demographics
NPI:1205584059
Name:INTEGRATED PHARMACY, LLC
Entity type:Organization
Organization Name:INTEGRATED PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:817-600-6413
Mailing Address - Street 1:7815 N PALM AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-5531
Mailing Address - Country:US
Mailing Address - Phone:559-476-8000
Mailing Address - Fax:
Practice Address - Street 1:7304 ALMA DR STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3563
Practice Address - Country:US
Practice Address - Phone:855-341-1449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy