MEDICARE: CITY DRUG PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1578368544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY DRUG PHARMACY

Provider Business Mailing Address
First Line	:	1722 CAREY AVE
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-4420
Country	:	US
Telephone Number	:	307-514-0200
Fax Number	:	833-384-2597

Provider Business Practice Location Address
First Line	:	309 W LINCOLNWAY
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-4437
Country	:	US
Telephone Number	:	307-514-0200
Fax Number	:	833-384-2597

Authorized Official
Title or Position	:	OWNER
Name	:	LUCAS HAUGH
Credential	:
Telephone Number	:	970-556-5698

Provider Enumeration Date	:	02/14/2025
Last Update Date	:	01/30/2026

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Directions to “CITY DRUG PHARMACY ” Practice Location

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