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General NPI Number Information
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NPI Number | 1700819919
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Entity Type | Organization
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Legal Business Name | ORION PHARMACY, INC.
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 1010 4TH ST
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City | ORION
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State | IL
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Zip | 61273-7731
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Country | US
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Telephone | 303-655-1041
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Fax |
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Provider Business Mailing Address
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Address Line | 4970 MT CAMERON DR
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City | BRIGHTON
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State | CO
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Zip | 80601-6797
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Country | US
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Telephone | 303-655-1041
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LYNN GERARD FYFE
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Credential | RPH
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Telephone | 303-655-1041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054013720
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License Number State | IL
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