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Individual

TOM SAM ROUGAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
25140 E US HIGHWAY 50, PUEBLO, CO 81006-9737
(719) 671-7683
Mailing address
93 PURDUE ST, PUEBLO, CO 81005-1633
(719) 671-7683

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
14904
OK
183500000X
Pharmacist
9153
CO
183500000X
Pharmacist
Primary
9163
CO

Other

Enumeration date
09/09/2020
Last updated
09/09/2020
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