NPI | 1578860805 |
---|---|
Doing Business As | BONNIE BRAE DRUGSTORE |
Entity Type | Organization |
Authorized Contact | BENJAMIN LAGER Owner/Manager 303-722-7892 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO PDO-816) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2011-02-23 |
Last Update Date | 2012-02-15 |