MEDICARE: PHARMACARE,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	830	CO
2	3336C0003X	Community/Retail Pharmacy	042917020001	CO

General Provider Information

NPI Number	:	1184908741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACARE,LLC

Provider Business Mailing Address
First Line	:	9450 E MISSISSIPPI AVE UNIT C
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-2427
Country	:	US
Telephone Number	:	303-755-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9450 E MISSISSIPPI AVE UNIT C
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-2427
Country	:	US
Telephone Number	:	303-755-2000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NIKOLAY LOPATIN
Credential	:
Telephone Number	:	303-755-2000

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	04/02/2014

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Directions to “PHARMACARE,LLC ” Practice Location

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