Organization
DILLON COMPANY
Active
Other names
King Soopers Pharmacy 063
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WENDELL MARK WOOLF RPH (DIRECTOR OF PHARMACY)
(513) 762-4672
Entity
Organization
Contact information
Practice address
8200 S HOLLY ST, CENTENNIAL, CO 80122-4012
(303) 779-4242
(303) 843-6021
Mailing address
8200 S HOLLY ST, CENTENNIAL, CO 80122-4012
(303) 779-4242
(303) 843-6021
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
79-7
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03485992
—
CO
01
—
0610267
NCPDP NUMBER
—
01
—
94523
MEDICARE MASS IMMUNIZER
—
Enumeration date
02/20/2007
Last updated
03/07/2023
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