Healthcare Provider Details

I. General information

NPI: 1598539785
Provider Name (Legal Business Name): LYON S CORNER DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 LINCOLN AVE
STEAMBOAT SPRINGS CO
80487-5005
US

IV. Provider business mailing address

840 LINCOLN AVE
STEAMBOAT SPRINGS CO
80487-5005
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-1114
  • Fax: 970-879-5643
Mailing address:
  • Phone: 970-879-1114
  • Fax: 970-879-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA JONES
Title or Position: OWNER
Credential: PHARMD
Phone: 970-879-1114