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General NPI Number Information
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NPI Number | 1508751066
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Entity Type | Organization
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Legal Business Name | BENNETT FAMILY PHARMACY INC
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 110 CENTENNIAL DR UNIT A
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City | BENNETT
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State | CO
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Zip | 80102-8794
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Country | US
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Telephone | 970-640-7698
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Fax |
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Provider Business Mailing Address
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Address Line | 764 KIO CT
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City | WATKINS
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State | CO
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Zip | 80137-8848
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Country | US
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Telephone | 970-640-7698
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS PAUL GIERWATOSKI
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Credential | R.PH.
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Telephone | 970-640-7698
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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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