Healthcare Provider Details

I. General information

NPI: 1558356667
Provider Name (Legal Business Name): ASSOCIATED PHARMACISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 2ND ST
FORT LUPTON CO
80621-1745
US

IV. Provider business mailing address

7490 CLUBHOUSE RD STE 102A
BOULDER CO
80301-3720
US

V. Phone/Fax

Practice location:
  • Phone: 303-857-1502
  • Fax: 720-274-5472
Mailing address:
  • Phone: 720-470-9080
  • Fax: 720-274-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number450000002
License Number StateCO

VIII. Authorized Official

Name: GREGORY DAVIS
Title or Position: PRESIDENT OWNER
Credential: RPH
Phone: 720-470-9080