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General NPI Number Information
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NPI Number | 1053498923
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Entity Type | Organization
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Legal Business Name | PCA VENTURES OF COLORADO LLC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 201 JOHNSTOWN CENTER DR
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City | JOHNSTOWN
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State | CO
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Zip | 80534-9073
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Country | US
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Telephone | 970-587-1128
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Fax | 970-587-1139
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Provider Business Mailing Address
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Address Line | PO BOX 88
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City | JOHNSTOWN
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State | CO
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Zip | 80534-0088
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHCY MGR
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Name | STEVE RAMSEY
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Credential | RPH
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Telephone | 970-587-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 609
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License Number State | CO
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