Organization
PHARMACA INTEGRATIVE PHARMACY, INC.
Active
Other names
Medly Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON FARRELL (SVP PHARMACY SERVICES)
(717) 254-9011
Entity
Organization
Contact information
Practice address
530 W CORDOVA RD, STE B, SANTA FE, NM 87505
(505) 820-7467
(505) 820-7697
Mailing address
7088 WINCHESTER CIR STE 100, BOULDER, CO 80301-3760
(303) 442-2304
(303) 867-4181
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY2692
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3211000
OTHER ID NUMBER
—
Enumeration date
12/18/2006
Last updated
05/11/2022
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