# LEVI PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KOHLERS APOTHECARY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619059656
- **Authorized official:** MR. JERRY DAVID LEVI R.PH. (PRESIDENT PHARMACY MANAGER)
- **Authorized official phone:** (719) 597-7998

## Contact information

- **Practice address:** 4020 PALMER PARK BLVD, 102C, COLORADO SPRINGS, CO 80909-3402
- **Practice address phone:** (719) 597-7998
- **Practice address fax:** (719) 597-6951
- **Mailing address:** 4020 PALMER PARK BLVD, 102C, COLORADO SPRINGS, CO 80909-3402
- **Mailing address phone:** (719) 597-7998
- **Mailing address fax:** (719) 597-6951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 9538 | CO | Yes |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 07/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03491255 | — | CO |
| 01 | — | 0602296 | NCPDP PROVIDER ID | — |