Organization
CENTRE PHARMACY INC
Active
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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