Organization
CENTRE PHARMACY INC
Active
Other names
CENTRE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ELLIS PHRM (PHRM MANG)
(970) 221-0190
Entity
Organization
Contact information
Practice address
915 CENTRE AVE, SUITE 4, FORT COLLINS, CO 80526-6045
(970) 221-0190
(970) 493-7680
Mailing address
915 CENTRE AVE, SUITE 4, FORT COLLINS, CO 80526-6045
(970) 221-0190
(970) 493-7680
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
440000002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03002250
—
CO
01
—
2002676
PK
—
Enumeration date
06/21/2005
Last updated
01/19/2017
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