| NPI | 1174600209 |
|---|---|
| Doing Business As | WHEAT RIDGE PROFESSIONAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JIM MASSENGILL President 303-421-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 1280000012) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-07-02 |