Healthcare Provider Details

I. General information

NPI: 1114394947
Provider Name (Legal Business Name): SADDLE ROCK PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 E BRIARWOOD AVE UNIT 152
CENTENNIAL CO
80112-6860
US

IV. Provider business mailing address

22962 E SMOKY HILL RD
AURORA CO
80016-1382
US

V. Phone/Fax

Practice location:
  • Phone: 720-353-4212
  • Fax: 720-353-4331
Mailing address:
  • Phone: 720-353-4212
  • Fax: 720-353-4331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. AKOSUA MENSA
Title or Position: PHARMACIST OWNER
Credential: PHARMD
Phone: 720-353-4212