Organization
GOOD SAMARITAN MEDICAL CENTER LLC
Active
Other names
GOOD SAMARITAN MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY CARSTENS RPH (DIRECTOR OF PHARMACY/LAB/PIC/AO)
(303) 689-4996
Entity
Organization
Contact information
Practice address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 689-6121
(303) 689-6126
Mailing address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 689-6121
(303) 689-6126
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO578
CO
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07856539
—
CO
01
—
2003760
PK
—
Enumeration date
07/24/2008
Last updated
09/13/2016
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