Healthcare Provider Details
I. General information
NPI: 1114962107
Provider Name (Legal Business Name): DILLON COMPANIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2006
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6930 N ACADEMY BLVD
COLORADO SPRINGS CO
80918
US
IV. Provider business mailing address
PO BOX 842772
BOSTON MA
02284-2772
US
V. Phone/Fax
- Phone: 719-598-5191
- Fax: 719-593-8851
- Phone: 513-762-1019
- Fax: 513-762-1092
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 240000029 |
| License Number State | CO |
VIII. Authorized Official
Name:
JESSIE
WARMAN
Title or Position: MANAGER OF PHARMACY LICENSING
Credential:
Phone: 513-762-1019