Organization
DILLON COMPANIES LLC
Active
Other names
KING SOOPERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
1150 HWY 287, BROOMFIELD, CO 80020
(303) 439-9040
(303) 439-9686
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
120000010
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003313
PK
—
05
—
42079772
—
CO
Enumeration date
06/20/2006
Last updated
08/09/2018
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