=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255591780
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METRO COMMUNITY PROVIDER NETWORK, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2008
-----------------------------------------------------
Last Update Date | 09/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3292 PEORIA STREET
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80110-1517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-343-6642
-----------------------------------------------------
Fax | 303-343-6932
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7495 W 29TH AVE
-----------------------------------------------------
City | WHEAT RIDGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80033-8002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-761-1977
-----------------------------------------------------
Fax | 303-343-0247
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MRS. APRIL J PEER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-761-1977
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------