Healthcare Provider Details

I. General information

NPI: 1649320037
Provider Name (Legal Business Name): FOLTMER DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 MAIN ST
WRAY CO
80758-1726
US

IV. Provider business mailing address

317 MAIN ST
WRAY CO
80758-1726
US

V. Phone/Fax

Practice location:
  • Phone: 970-332-4911
  • Fax: 970-332-2053
Mailing address:
  • Phone: 970-332-4911
  • Fax: 970-332-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1310000001
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN H EVERETT
Title or Position: CFO
Credential:
Phone: 970-332-2201