Organization
REAMS PALACE DRUG INC
Active
Other names
PALACE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHELVER PHARMD (CEO)
(719) 275-3375
Entity
Organization
Contact information
Practice address
601 MAIN ST, CANON CITY, CO 81212-3736
(719) 275-3375
(719) 275-4756
Mailing address
PO BOX 159, CANON CITY, CO 81212
(719) 275-3375
(719) 275-4756
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
170000004
CO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03735081
—
CO
01
—
2000845
PK
—
Enumeration date
10/25/2006
Last updated
08/01/2022
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