| 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 |