Organization
SHAVANO PHARMACY LLC
Active
Other names
Shavano Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA ANNE SEAMAN RPH (OWNER/PHARMACIST)
(719) 398-6550
Entity
Organization
Contact information
Practice address
415 US HIGHWAY 24 N, BUENA VISTA, CO 81211
(816) 804-6412
Mailing address
7290 W US HIGHWAY 50, SALIDA, CO 81201-9340
(719) 398-6550
(719) 398-6560
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053755363
—
CO
Enumeration date
05/05/2020
Last updated
11/17/2020
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