Organization
BERTHOUD DRUG, LLC
Active
Other names
BERTHOUD DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA ELIJAH JONES PHARMD (OWNER)
(970) 532-2034
Entity
Organization
Contact information
Practice address
1241 LAKE AVE, BERTHOUD, CO 80513
(970) 532-2034
(970) 532-4799
Mailing address
1241 LAKE AVE, BERTHOUD, CO 80513
(970) 532-2034
(970) 532-4799
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0080000001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000864
PK
—
05
—
36601365
—
CO
Enumeration date
09/13/2006
Last updated
08/05/2024
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