Organization
DILLON COMPANIES LLC
Active
Other names
King Soopers Pharmacy #114
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
15051 E 104TH AVE, COMMERCE CITY, CO 80022
(303) 286-5470
(303) 286-5472
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134881
PK
—
05
—
56400047
—
CO
Enumeration date
04/25/2012
Last updated
08/08/2018
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