Organization
TMB CORPORATION
Active
Organization
TMB CORPORATION
Active
Other names
Abts Pharmacy Haxtun
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BUMGARDNER (OWNER/PRESIDENT/PHARMACIST)
(970) 474-3672
Entity
Organization
Contact information
Practice address
235 W FLETCHER ST, HAXTUN, CO 80731-2737
(970) 774-3784
(970) 774-3785
Mailing address
235 W FLETCHER ST, HAXTUN, CO 80731-2737
(970) 474-3411
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1680000002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622654
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
44108877
—
CO
Enumeration date
07/10/2012
Last updated
02/18/2013
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