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Organization

PHARMACA INTERGRATIVE PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREG LEGORE (CEO)
(805) 217-9926
Entity
Organization

Contact information

Practice address
1647 PEARL ST, BOULDER, CO 80302-5410
(303) 442-5164
Mailing address
4940 PEARL EAST CIR STE 301, BOULDER, CO 80301-2442
(303) 867-3181

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
58-322272
CO
Enumeration date
12/19/2006
Last updated
05/20/2019
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