Healthcare Provider Details

I. General information

NPI: 1437284908
Provider Name (Legal Business Name): RIDGWAY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 PALOMINO WAY
RIDGWAY CO
81432
US

IV. Provider business mailing address

PO BOX 1190
RIDGWAY CO
81432-1190
US

V. Phone/Fax

Practice location:
  • Phone: 970-626-3440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number550
License Number StateCO

VIII. Authorized Official

Name: DONNA M SHERWOOD
Title or Position: OWNER
Credential: RPH
Phone: 970-626-3440