| NPI | 1396309829 |
|---|---|
| Doing Business As | PROFESSIONAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KEN WATERHOUSE CFO 719-532-9705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |