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General NPI Number Information
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NPI Number | 1114414604
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Entity Type | Organization
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Legal Business Name | ORIGIN HEALTHLINK LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 7720 S BROADWAY STE 100
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City | LITTLETON
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State | CO
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Zip | 80122-2624
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Country | US
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Telephone | 720-627-6123
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Fax | 720-627-6129
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Provider Business Mailing Address
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Address Line | 7720 S BROADWAY STE 100
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City | LITTLETON
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State | CO
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Zip | 80122-2624
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Country | US
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Telephone | 720-627-6123
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Fax | 720-627-6129
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | UYEN LE
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Credential |
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Telephone | 720-627-6123
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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 | 1680000167
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License Number State | CO
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