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Organization

WHEATRIDGE DRUG STORE LLC

Active
Other names
Wheat Ridge Professional Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
WENDY DILORENZO (OFFICE MANAGER)
(303) 421-6111
Entity
Organization

Contact information

Practice address
6650 W 38TH AVE, WHEAT RIDGE, CO 80033-4906
(303) 421-6111
(303) 431-8320
Mailing address
6650 W 38TH AVE, WHEAT RIDGE, CO 80033-4906
(303) 421-6111
(303) 431-8320

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
1280000012
CO
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2151932
PK
05
5080-3883
CO
Enumeration date
02/24/2015
Last updated
10/28/2021
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