Organization
1200 MADISON SREET INC
Active
Other names
CAPITOL HEIGHTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIT DHALIWAL (PRESIDENT)
(303) 388-3679
Entity
Organization
Contact information
Practice address
1200 MADISON ST, DENVER, CO 80206-3440
(303) 388-3679
(303) 393-7604
Mailing address
1200 MADISON ST, DENVER, CO 80206-3440
(303) 388-3679
(303) 393-7604
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PDO30
CO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601496
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
62103571
—
CO
Enumeration date
06/19/2006
Last updated
02/07/2011
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