| NPI | 1861412330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT JOHNSON Manager 719-275-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 17-3) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |