| NPI | 1760401046 |
|---|---|
| Doing Business As | BASALT CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TAD ANDERSON Owner And PIC 970-927-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 1330000001) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-01-18 |