Organization
ANDERSON FAMILY PHARMACY, INC
Active
Other names
BASALT CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TAD ANDERSON RPH (OWNER AND PIC)
(970) 927-3833
Entity
Organization
Contact information
Practice address
110 MIDLAND AVE, BASALT, CO 81621-8305
(970) 927-3833
(970) 927-2538
Mailing address
PO BOX 1939, BASALT, CO 81621-1939
(970) 927-3833
(970) 927-2538
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1330000001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03002383
—
CO
01
—
2002678
PK
—
Enumeration date
07/18/2006
Last updated
01/18/2017
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