Organization
COBIGRED INC
Active
Other names
Hometown Pharmacy and Medical
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK SCHEELS (SECRETARY/OWNER)
(303) 898-7183
Entity
Organization
Contact information
Practice address
824 E MAIN ST, TRINIDAD, CO 81082-2782
(719) 845-0069
(719) 846-8439
Mailing address
824 E MAIN ST, TRINIDAD, CO 81082-2782
(719) 845-0069
(719) 846-8439
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
557
CO
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622755
NCPDP
CO
01
—
1053673699
NPI
CO
01
—
2137541
PK
—
05
—
59624574
—
CO
Enumeration date
06/11/2012
Last updated
06/15/2015
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