Organization
APOTHECA LLC
Active
Other names
Apotheca Integrative Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE COMMON (MANAGING MMBR/OWNER/PHARM MGR)
(970) 708-9982
Entity
Organization
Contact information
Practice address
129 W. COLORADO AVENUE, TELLURIDE, CO 81435
(970) 728-0488
(970) 728-0487
Mailing address
PO BOX 3270, TELLURIDE, CO 81435-3270
(970) 728-0488
(970) 728-0487
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO0000000805
CO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16259220
—
CO
01
—
2126604
PK
—
Enumeration date
09/10/2010
Last updated
03/29/2017
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