Organization
MEDIZINE MAN INC.
Active
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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