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General NPI Number Information
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NPI Number | 1346909199
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Entity Type | Organization
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Legal Business Name | PHARMACY AT MATTHEWS-VU, LLC
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 4190 E WOODMEN RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8075
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Country | US
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Telephone | 719-632-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 4190 E WOODMEN RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8075
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Country | US
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Telephone | 719-632-4455
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | KATE BOGUE
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Credential |
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Telephone | 703-776-0108
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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 |
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