Organization
PARK AVE APOTHECARY LLC
Active
Parent organization
PARK AVE APOTHECARY
Other names
Medicine Shoppe #437
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK AVE APOTHECARY
Authorized official
PATRICK SCHEELS (OWNER)
(303) 898-7183
Entity
Organization
Contact information
Practice address
2431 N UNION BLVD, COLORADO SPRINGS, CO 80909-1107
(719) 630-3154
(719) 630-1640
Mailing address
2431 N UNION BLVD, COLORADO SPRINGS, CO 80909-1107
(719) 630-3154
(719) 630-1640
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03577319
—
CO
01
—
240000040
STATE PHARMACY LICENSE
CO
01
—
7599910001
PTAN
—
Enumeration date
07/16/2019
Last updated
07/16/2019
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