Healthcare Provider Details

I. General information

NPI: 1649570516
Provider Name (Legal Business Name): THOMAS PUTNEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7655 MCLAUGHLIN RD
FALCON CO
80831-4727
US

IV. Provider business mailing address

7655 MCLAUGHLIN RD
FALCON CO
80831-4727
US

V. Phone/Fax

Practice location:
  • Phone: 719-495-7400
  • Fax:
Mailing address:
  • Phone: 719-495-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18021
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: