Organization
PURGATORY PHARMACEUTICAL SERVICES LLC
Active
Other names
Jack's Market Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
IAN MCMULLEN PHARMD (MANAGING MEMBER, PHARMACIST)
(719) 852-9894
Entity
Organization
Contact information
Practice address
222 SOLAR AVE, MONTE VISTA, CO 81144-1066
(719) 852-9894
(719) 852-9897
Mailing address
PO BOX 546, CRESTONE, CO 81131-0546
(719) 852-9894
(719) 852-9897
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
10/17/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us