Healthcare Provider Details

I. General information

NPI: 1184594681
Provider Name (Legal Business Name): KATARINA GURESIC RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MARKET ST
EAGLE CO
81631
US

IV. Provider business mailing address

PO BOX 293
EDWARDS CO
81632-0293
US

V. Phone/Fax

Practice location:
  • Phone: 970-328-1311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0025366
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: