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General NPI Number Information
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NPI Number | 1972694990
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Entity Type | Organization
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Legal Business Name | PRESCRIPTION SHOP LLC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1728 S PRAIRIE AVE
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City | PUEBLO
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State | CO
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Zip | 81005-2253
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Country | US
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Telephone | 719-564-0220
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Fax | 719-564-0424
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Provider Business Mailing Address
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Address Line | 1728 S PRAIRIE AVE
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City | PUEBLO
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State | CO
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Zip | 81005-2253
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Country | US
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Telephone | 719-564-0220
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Fax | 719-564-0424
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Authorized Official
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Title or Position | SENIOR MEMBER
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Name | JAMES T SAJBEL
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Credential | RPH
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Telephone | 719-564-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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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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