Organization
OPERA HOUSE PHARMACY CO INC
Active
Other names
OPERA HOUSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD VASQUEZ R.PH (PRESIDENT)
(719) 384-2521
Entity
Organization
Contact information
Practice address
223 COLORADO AVE, LA JUNTA, CO 81050-1517
(719) 384-2521
(719) 384-2523
Mailing address
223 COLORADO AVE, PO BOX 377, LA JUNTA, CO 81050-1517
(719) 384-2521
(719) 384-2523
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
720000007
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03628500
—
CO
01
—
2000783
PK
—
Enumeration date
01/16/2007
Last updated
10/12/2016
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