Organization
PIONEER PHARMACY LLC
Active
Other names
PIONEER PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON HAGEN (OWNER)
(303) 525-7990
Entity
Organization
Contact information
Practice address
3895 UPHAM ST, STE 60, WHEAT RIDGE, CO 80033-4651
(303) 252-7990
(303) 252-7991
Mailing address
PO BOX 329, RIVERTON, UT 84065-0329
(303) 252-2990
(303) 252-7991
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
643
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003854
PK
—
05
—
A5857059
—
CO
Enumeration date
01/06/2006
Last updated
11/04/2016
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