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General NPI Number Information
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NPI Number | 1215002423
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Entity Type | Organization
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Legal Business Name | CITY PHARMACY
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 319 MAIN ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2108
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Country | US
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Telephone | 970-867-5608
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Fax | 970-867-4724
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Provider Business Mailing Address
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Address Line | 319 MAIN ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2108
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Country | US
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Telephone | 970-867-5608
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Fax | 970-867-4724
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANE LUMPKIN
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Credential |
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Telephone | 970-867-5608
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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 |
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License Number State | CO
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