| NPI | 1942365002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE MARIE BURNS Manager Owner 719-545-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO PDO1040000035) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 1040000035) |
| 333600000X Pharmacy (Licence: CO PDO1040000035) | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-11-24 |