Individual
JAMES SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 524-4410
Mailing address
6680 BEAR TOOTH DR, COLORADO SPRINGS, CO 80923-5119
(913) 702-4225
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100284
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-100284
PHARMACIST
KS
Enumeration date
01/08/2019
Last updated
01/08/2019
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