Organization
JB PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE MARIE BURNS (MANAGER-OWNER)
(719) 545-1811
Entity
Organization
Contact information
Practice address
915 W NORTHERN AVE, PUEBLO, CO 81004-3123
(719) 545-1811
(719) 545-3878
Mailing address
915 W NORTHERN AVE, PUEBLO, CO 81004-3123
(719) 545-1811
(719) 545-3878
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
1040000035
CO
333600000X
Pharmacy
PDO1040000035
CO
3336C0003X
Community/Retail Pharmacy
Primary
PDO1040000035
CO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032190001
PTAN
CO
05
—
03708781
—
CO
Enumeration date
12/27/2006
Last updated
11/24/2020
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