Healthcare Provider Details

I. General information

NPI: 1962316133
Provider Name (Legal Business Name): DEDMANPHARMACIES@GMAIL.COM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 S PARK SQ STE 101
FRUITA CO
81521-2541
US

IV. Provider business mailing address

770 PONDEROSA DR
FRUITA CO
81521-9616
US

V. Phone/Fax

Practice location:
  • Phone: 970-270-0524
  • Fax:
Mailing address:
  • Phone: 970-270-0524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JEFFREY K DEDMAN
Title or Position: OWNER
Credential: PHARM.D.
Phone: 970-270-0524