Healthcare Provider Details

I. General information

NPI: 1255004172
Provider Name (Legal Business Name): GARRETT JOHNSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 N MAIN ST
GUNNISON CO
81230-2414
US

IV. Provider business mailing address

305 VAN TUYL CIR UNIT A
GUNNISON CO
81230-2998
US

V. Phone/Fax

Practice location:
  • Phone: 970-641-6379
  • Fax:
Mailing address:
  • Phone: 970-596-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0023624
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: