| NPI | 1255468831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE LALLIER Pharmacist 719-539-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 1090000001) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-09-12 |