Organization
ANDERSON FAMILY PHARMACY, INC
Active
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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