Organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Active
Other names
Intermountain Pharmacy #09, Intermountain Health Lutheran Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MATT D HIGLEY (AVP, PHARMACY SERVICES)
(801) 609-8246
Entity
Organization
Contact information
Practice address
12911 W 40TH AVE, WHEAT RIDGE, CO 80401
(303) 403-6420
Mailing address
8300 W 38TH AVE STE T2-105, WHEAT RIDGE, CO 80033-6005
(303) 403-6420
(303) 403-6909
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629515028
—
CO
01
—
2168336
PK
—
Enumeration date
01/23/2017
Last updated
05/11/2026
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