Organization
PHARMACA INTEGRATIVE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KRUTECK (CFO)
(303) 867-3163
Entity
Organization
Contact information
Practice address
4139 CAMPUS DR, IRVINE, CA 92612-2645
(949) 823-9762
(949) 823-9763
Mailing address
7088 WINCHESTER CIR, BOULDER, CO 80301-3760
(303) 442-2304
(303) 867-4180
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
48639
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5627661
OTHER ID NUMBER
—
Enumeration date
07/25/2007
Last updated
01/24/2022
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