Organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Active
Other names
Intermountain Health Good Samaritan Pharmacy, Intermountain Pharmacy #07, Intermountain Good Samaritan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MATT D HIGLEY (VP, PHARMACY SERVICES)
(801) 609-8246
Entity
Organization
Contact information
Practice address
200 EXEMPLA CIR STE P1-142, LAFAYETTE, CO 80026-3370
(303) 689-6121
(303) 689-6126
Mailing address
PO BOX 912960, DENVER, CO 80291-2960
(303) 689-6121
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
PDO.1680000162
CO
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176193
PK
—
Enumeration date
01/23/2017
Last updated
05/11/2026
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