Organization
HAVANA PHARMACY AND MEDICAL SUPPLY LLC
Active
Organization
HAVANA PHARMACY AND MEDICAL SUPPLY LLC
Active
Other names
Havana Pharmacy and Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SACKEY RPH (PHARMACIST/OWNER)
(303) 668-0032
Entity
Organization
Contact information
Practice address
1555 S HAVANA ST UNIT HJ, AURORA, CO 80012-5004
(303) 750-3600
(303) 750-3607
Mailing address
1555 S HAVANA ST UNIT HJ, AURORA, CO 80012-5004
(303) 750-3600
(303) 750-3607
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
836
CO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622363
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/13/2011
Last updated
03/20/2014
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