Healthcare Provider Details

I. General information

NPI: 1710055538
Provider Name (Legal Business Name): BATSON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 BROADWAY ST
EAGLE CO
81631-9001
US

IV. Provider business mailing address

PO BOX 1473
EAGLE CO
81631-1473
US

V. Phone/Fax

Practice location:
  • Phone: 970-328-6875
  • Fax: 970-328-2050
Mailing address:
  • Phone: 970-328-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number340000001
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN BATSON
Title or Position: OWNER
Credential:
Phone: 970-328-6875