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Organization
REAMS PALACE DRUG INC
Active
Organization
REAMS PALACE DRUG INC
Active
Other names
PALACE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHELVER PHARMD (CEO)
(719) 275-3375
Entity
Organization
Contact information
Practice address
601 MAIN ST, CANON CITY, CO 81212-3736
(719) 275-3375
(719) 275-4756
Mailing address
PO BOX 159, CANON CITY, CO 81212
(719) 275-3375
(719) 275-4756
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
170000004
CO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03735081
—
CO
01
—
2000845
PK
—
Enumeration date
10/25/2006
Last updated
08/01/2022
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