| NPI | 1154798197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HANER Pharmacist 970-290-6802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 11824) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |