# LA CLINICA TEPEYAC, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tepeyac Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275230328
- **Authorized official:** CAROLA REGINA DONOHOO (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (720) 274-2923

## Contact information

- **Practice address:** 2101 E 48TH AVE, DENVER, CO 80216-2253
- **Practice address phone:** (303) 458-5302
- **Mailing address:** 4725 HIGH ST, DENVER, CO 80216-2220
- **Mailing address phone:** (303) 458-5302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 02/09/2023
- **Last updated:** 02/09/2023