Organization
ASPEN GROCERY INC
Active
Other names
Clarks Pharmacy Aspen
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE JOHNSON PHARMD (PHARMACY MANAGER/PIC)
(970) 925-2728
Entity
Organization
Contact information
Practice address
300 PUPPY SMITH ST, ASPEN, CO 81611-1455
(970) 925-2728
(970) 544-4201
Mailing address
818 S MAIN ST, BLANDING, UT 84511-3911
(970) 925-5295
(970) 925-5296
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
813
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128457
PK
—
05
—
67132588
—
CO
Enumeration date
01/15/2011
Last updated
11/22/2016
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