Organization
LJCC SERVICES, LLC
Active
Organization
LJCC SERVICES, LLC
Active
Other names
Salida Pharmacy & Fountain
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCAS SMITH PHARMD (OWNER)
(719) 460-1465
Entity
Organization
Contact information
Practice address
137 F STREET, SALIDA, CO 81201
(719) 530-4790
(719) 530-4791
Mailing address
137 F ST, SALIDA, CO 81201-2101
(719) 530-4790
(719) 530-4791
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000178623
—
CO
01
—
TDPO.0000008
COLORADO STATE BOARD OF PHARMACY
CO
Enumeration date
10/07/2019
Last updated
08/06/2024
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