Organization
RIO GRANDE PHARMACY LLC
Active
Other names
Rio Grande Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIA CAMPBELL PHARMD (OWNER/PIC)
(719) 657-3513
Entity
Organization
Contact information
Practice address
650 GRAND AVE, DEL NORTE, CO 81132-2206
(719) 657-3513
(719) 657-3845
Mailing address
650 GRAND AVE, DEL NORTE, CO 81132-2206
(719) 657-3513
(719) 657-3845
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
280000001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130147
PK
—
05
—
35078243
—
CO
Enumeration date
05/03/2011
Last updated
01/18/2017
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