Organization
COLUMBINE MARKET, INC
Active
Organization
COLUMBINE MARKET, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W GEDDES RPH (DIRECTOR OF PHARMACY OPERATIONS)
(970) 524-1125
Entity
Organization
Contact information
Practice address
0210 CRESTWOOD DRIVE, GYPSUM, CO 81637-1220
(970) 524-1125
(970) 524-0478
Mailing address
PO BOX 1220, GYPSUM, CO 81637-1220
(970) 524-1125
(970) 524-0478
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
572
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0619176
NCPDP NUMBER
—
05
—
97975770
—
CO
Enumeration date
10/04/2006
Last updated
03/18/2009
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