| NPI | 1912909987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN N STACKHOUSE PIC 970-494-2130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CO 440000021) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: CO 440000021) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CO 440000021) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: 440000021) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2026-05-18 |