Organization
DCRX INFUSION
Active
Other names
DIABETIC CARE RX
Organization subpart
No
Provider details
NPI number
Authorized official
JASARA MOHAMMED (COO)
(954) 473-4717
Entity
Organization
Contact information
Practice address
6821 W 120TH AVE, STE A, BROOMFIELD, CO 80020-2308
(303) 469-1559
(720) 887-3003
Mailing address
6821 W 120TH AVE, STE A, BROOMFIELD, CO 80020-2308
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PDO707
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0620547
OTHER ID NUMBER
—
Enumeration date
11/05/2007
Last updated
11/07/2007
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