Organization Name: | LA JARA PHARMACEUTICAL CENTER, INC. |
NPI Number: | 1346336997 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH THOMAS VALDEZ (PHARMACIST OWNER) |
Mailing Address: | 412 Main Street La Jara |
State: | CO US |
Postal Code: | 81140 |
Phone Number: | 7192745109 |
Fax Number: | 7192744246 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 01/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | AL7908114 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |