Healthcare Provider Details

I. General information

NPI: 1770814774
Provider Name (Legal Business Name): NICHOLAS HOLDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 MAIN AVE
DURANGO CO
81301-4247
US

IV. Provider business mailing address

3130 MAIN AVE
DURANGO CO
81301-4247
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-9435
  • Fax:
Mailing address:
  • Phone: 970-247-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0021182
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: