Organization
INTEGRA NETWORK CORP
Active
Other names
Integra Rx
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ANTONIO (PRESIDENT)
(954) 917-6813
Entity
Organization
Contact information
Practice address
2661 W ATLANTIC BLVD, POMPANO BEACH, FL 33069-2507
(954) 917-6813
(954) 917-6814
Mailing address
2661 W ATLANTIC BLVD, POMPANO BEACH, FL 33069-2507
(954) 917-6813
(954) 917-6814
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24183
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001560800
—
FL
01
—
2121287
PK
—
Enumeration date
07/30/2009
Last updated
09/16/2016
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