Individual
MRS. EILEEN DIANA WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
45 FRONTAGE RD, FAIRPLAY, CO 80440
(719) 836-3366
(719) 836-1743
Mailing address
PO BOX 1179, FAIRPLAY, CO 80440
(719) 836-3366
(719) 836-1743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
14785
CO
183500000X
Pharmacist
Primary
1570000001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14785
CO STATE BOARD RX
CO
01
—
1570000001
CO STATE BOARD RX
CO
05
—
98532383
—
CO
Enumeration date
08/09/2006
Last updated
03/07/2023
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