Organization
KUSHMART
Active
Organization
KUSHMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM SCOTT JOHNSON (OWNER)
(702) 630-1610
Entity
Organization
Contact information
Practice address
4095 JACKSON ST, DENVER, CO 80216-6522
(702) 630-1610
Mailing address
4095 JACKSON ST, DENVER, CO 80216-6522
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
427721
CO
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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