Healthcare Provider Details
I. General information
NPI: 1053332007
Provider Name (Legal Business Name): BGS PHARMACY PARTNERS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2006
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4465 NORTHPARK DR STE #303
COLORADO SPRINGS CO
80907
US
IV. Provider business mailing address
4465 NORTHPARK DR STE #303
COLORADO SPRINGS CO
80907
US
V. Phone/Fax
- Phone: 719-471-7810
- Fax: 719-471-7804
- Phone: 719-471-7810
- Fax: 719-471-7804
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | 240000124 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 240000124 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 240000124 |
| License Number State | CO |
VIII. Authorized Official
Name:
EILENE
RIEBER
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 719-741-7810