Organization
MVPS LLC
Active
Other names
JACKS MARKET PHARMACY, Jack's Market Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW HUTERA (MANAGING MEMBER)
(651) 214-3762
Entity
Organization
Contact information
Practice address
222 SOLAR AVE, MONTE VISTA, CO 81144-1066
(719) 852-9894
(719) 852-9897
Mailing address
903 87TH AVE, HUDSON, WI 54016-7074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
546
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618857
OTHER ID NUMBER
—
05
—
06674542
—
CO
Enumeration date
01/22/2007
Last updated
01/28/2022
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