Organization
MAPLE ROSE ENTERPRISES
Active
Other names
Pencol Compouding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY JONES (PRESIDENT)
(303) 388-1674
Entity
Organization
Contact information
Practice address
1325 S COLORADO BLVD, STE B-024, DENVER, CO 80222-3303
(303) 388-3613
(303) 388-6182
Mailing address
2079 ALBION ST, DENVER, CO 80207-3705
(303) 320-0495
(303) 388-5507
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
168-87
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150138
PK
—
Enumeration date
02/06/2015
Last updated
02/06/2015
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