=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467672808
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RXPLUS LIMITED COLORADO CITY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 09/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4493 BENT BROTHERS BLVD
-----------------------------------------------------
City | COLORADO CITY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81019-0157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-676-3333
-----------------------------------------------------
Fax | 719-676-3985
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3780 E 15TH ST SUITE 102
-----------------------------------------------------
City | LOVELAND
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80538-8766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-461-1975
-----------------------------------------------------
Fax | 970-461-4042
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | VICKILEE EINHELLIG
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 970-461-1975
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 830000002
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------