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General NPI Number Information
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NPI Number | 1568498426
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Entity Type | Organization
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Legal Business Name | SENIORX PHARMACY LLC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 S ARTHUR AVE SUITE 300B
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City | LOUISVILLE
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State | CO
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Zip | 80027-3065
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Country | US
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Telephone | 303-664-0066
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Fax | 303-664-0099
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Provider Business Mailing Address
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Address Line | 500 S ARTHUR AVE SUITE 300B
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City | LOUISVILLE
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State | CO
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Zip | 80027-3065
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Country | US
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Telephone | 303-664-0066
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Fax | 303-664-0099
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. MERRICK L SHIVELY
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Credential | R.PHD
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Telephone | 303-664-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 613
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License Number State | CO
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