Organization
CDE LLC
Active
Other names
City Drug
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CANNON (MANAGER)
(307) 789-4000
Entity
Organization
Contact information
Practice address
131 10TH ST, EVANSTON, WY 82930-3421
(307) 789-4000
(307) 444-4000
Mailing address
131 10TH ST, EVANSTON, WY 82930-3421
(307) 789-4000
(307) 444-4000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
R10068
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136938500
—
WY
01
—
2144273
PK
—
Enumeration date
01/28/2014
Last updated
10/08/2020
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