Organization
SANO VITA INC
Active
Other names
Rivergate Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LORI JEAN KEARNEY (OWNER/RPH/PHARMACIST IN CHARGE)
(970) 375-7711
Entity
Organization
Contact information
Practice address
575 RIVERGATE, STE 111, DURANGO, CO 81301-7487
(970) 375-7711
(970) 375-7722
Mailing address
575 RIVERGATE, STE 111, DURANGO, CO 81301-7487
(970) 375-7711
(970) 375-7722
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
592
CO
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124401
PK
—
05
—
78452881
—
CO
Enumeration date
03/16/2010
Last updated
04/16/2024
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