MEDICARE: ALTO PHARMACY, LLC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PDO.1680000207	OTHER	CO	PHARMACY PERMIT

General Provider Information

NPI Number	:	1679107486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTO PHARMACY, LLC

Provider Business Mailing Address
First Line	:	8407 FIREBIRD DR STE 300
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45014-2348
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Provider Business Practice Location Address
First Line	:	1062 DELAWARE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4033
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Authorized Official
Title or Position	:	SR. MANAGER OF REIMBURSEMENT
Name	:	LAUREN HAMMOND
Credential	:
Telephone Number	:	800-874-5881

Provider Enumeration Date	:	03/02/2020
Last Update Date	:	05/27/2026

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