Organization
REAL WORLD ENTERPRISES, INC
Active
Other names
Four Square, PPS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD WILSON (PRESIDENT)
(858) 336-1821
Entity
Organization
Contact information
Practice address
4803 INNOVATION DR, UNIT 2, FORT COLLINS, CO 80525-7307
(970) 223-1930
Mailing address
4803 INNOVATION DR, UNIT 2, FORT COLLINS, CO 80525-7307
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
PDO-843
CO
3336S0011X
Specialty Pharmacy
Primary
PDO-843
CO
Other
Enumeration date
05/21/2012
Last updated
02/04/2014
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