Organization
MEDIZINE MAN INC.
Active
Other names
Platte Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS GIERWATOSKI R.PH. (PRESIDENT)
(970) 640-7698
Entity
Organization
Contact information
Practice address
1610 PRAIRIE CENTER PKWY, SUITE 2110, BRIGHTON, CO 80601-4000
(303) 483-7455
(303) 483-7456
Mailing address
1610 PRAIRIE CENTER PKWY, SUITE 2110, BRIGHTON, CO 80601-4000
(303) 483-7455
(303) 483-7456
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
690
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0620369
NCPDP NUMBER
CO
05
—
36776858
—
CO
Enumeration date
06/15/2007
Last updated
07/09/2020
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