| NPI | 1306249024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON WAYNE FERLAS Pharmacy Manager 720-627-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO PDO.1680000062) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CO PDO.1680000062) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2016-03-24 |