Healthcare Provider Details

I. General information

NPI: 1134164809
Provider Name (Legal Business Name): DILLON COMPANIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4503 JOHN F KENNEDY PKWY
FORT COLLINS CO
80525
US

IV. Provider business mailing address

PO BOX 842772
BOSTON MA
02284-2772
US

V. Phone/Fax

Practice location:
  • Phone: 970-223-5769
  • Fax: 970-223-5844
Mailing address:
  • Phone: 513-762-1019
  • Fax: 513-762-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number440000052
License Number StateCO

VIII. Authorized Official

Name: JESSIE WARMAN
Title or Position: MANAGER OF PHARMACY LICENSING
Credential:
Phone: 513-762-1019