Organization
WELLS PHARMACY
Active
Organization
WELLS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE EDMUND BILLINGER JR. R. PH. (OWNER)
(719) 767-5676
Entity
Organization
Contact information
Practice address
180 SO. 1 E., CHEYENNE WELLS, CO 80810-0005
(719) 767-5676
(719) 767-5448
Mailing address
PO BOX 5, CHEYENNE WELLS, CO 80810-0005
(719) 767-5676
(719) 767-5448
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
230000002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03000429
—
CO
Enumeration date
10/27/2006
Last updated
06/18/2008
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