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
2255 MAIN ST, LONGMONT, CO 80501
(303) 772-7552
(303) 682-7443
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
800000014
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03485513
—
CO
01
—
2001387
PK
—
Enumeration date
06/29/2006
Last updated
08/07/2018
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