| NPI | 1487275129 |
|---|---|
| Former Legal Business Name | SHAVANO PHARMACY LLC |
| Entity Type | Organization |
| Authorized Contact | REBECCA ANNE SEAMAN Owner/Pharmacist 719-398-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-11-17 |