=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780232215
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OLATHE COMMUNITY CLINIC INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2019
-----------------------------------------------------
Last Update Date | 02/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 S RIO GRANDE
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-787-2044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 529
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81425-0529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PHARMACY
-----------------------------------------------------
Name | CHELSEA E PRICE
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 970-787-2044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------