| Salida Pharmacy & Fountain | |
|
137 F Street Salida CO 81201 | |
| (719) 530-4790 | |
| (719) 530-4791 |
| Full Name | Salida Pharmacy & Fountain |
|---|---|
| Speciality | Pharmacy |
| Location | 137 F Street, Salida, Colorado |
| Authorized Official Name and Position | Lucas Smith (OWNER) |
| Authorized Official Contact | 7194601465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salida Pharmacy & Fountain 137 F St Salida CO 81201-2101 Ph: (719) 530-4790 | Salida Pharmacy & Fountain 137 F Street Salida CO 81201 Ph: (719) 530-4790 |
| NPI Number | 1740821289 |
|---|---|
| Provider Enumeration Date | 10/07/2019 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 1153753371 |
|---|---|
| Medicare Enrollment ID | O20191108002020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740821289 | NPI | - | NPPES |
| 9000178623 | Medicaid | CO | |
| TDPO.0000008 | Other | CO | COLORADO STATE BOARD OF PHARMACY |
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