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General NPI Number Information
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NPI Number | 1851386841
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Entity Type | Organization
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Legal Business Name | COLORADO PHARMACY LLC
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1245 E COLFAX AVE
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City | DENVER
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State | CO
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Zip | 80218-2238
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Country | US
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Telephone | 303-863-7644
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Fax | 303-863-7656
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Provider Business Mailing Address
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Address Line | PO BOX 300127
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City | DENVER
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State | CO
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Zip | 80203-0127
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Country | US
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Telephone | 303-863-7644
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Fax | 303-863-7656
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANE NICHOLS
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Credential |
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Telephone | 303-863-7644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 302
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License Number State | CO
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