Healthcare Provider Details

I. General information

NPI: 1801521273
Provider Name (Legal Business Name): HONEST OAK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/20/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 M AVE STE 100
LIMON CO
80828-2239
US

IV. Provider business mailing address

PO BOX 130
LIMON CO
80828-0130
US

V. Phone/Fax

Practice location:
  • Phone: 719-775-0500
  • Fax: 719-775-0500
Mailing address:
  • Phone: 719-775-0500
  • Fax: 719-775-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUSAN FERREE
Title or Position: PHARMACIST IN CHARGE
Credential: PHARM.D.
Phone: 309-750-1827