=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245549682
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C J PHARMACYSERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2010
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 422 MAIN ST
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751-4343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-522-0190
-----------------------------------------------------
Fax | 970-522-7589
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 531
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751-0531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-522-0190
-----------------------------------------------------
Fax | 970-522-7589
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACY MANAGER
-----------------------------------------------------
Name | JENAE LORENZO-LOCK
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 970-526-9417
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PDO1680000109
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------