# SHAVANO PHARMACY LLC

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

## Provider details

- **NPI number:** 1487275129
- **Authorized official:** REBECCA ANNE SEAMAN RPH (OWNER/PHARMACIST)
- **Authorized official phone:** (719) 398-6550

## Contact information

- **Practice address:** 415 US HIGHWAY 24 N, BUENA VISTA, CO 81211
- **Practice address phone:** (816) 804-6412
- **Mailing address:** 7290 W US HIGHWAY 50, SALIDA, CO 81201-9340
- **Mailing address phone:** (719) 398-6550
- **Mailing address fax:** (719) 398-6560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2020
- **Last updated:** 11/17/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1053755363 | — | CO |