Dennis Mortensen

LBN: Peoples Drug Store
Dennis Mortensen is an health care organization with primary practice located at 327 Main St , Antonito CO 81120. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Peoples Drug Store can be contacted via phone (719) 376-5450, or through Mortensen, Dennis via phone (719) 376-5450.

Contact Information

Primary practice address
327 Main St Antonito CO 81120
Fax: (719) 376-6362
Website:
Authorized official contact:
Name: Mortensen, Dennis

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X 30000002 Colorado

Profile Details

NPI number 1952431694
LBN Legal business name Peoples Drug Store
DBA Doing business as Dennis Mortensen
Authorized official Mortensen, Dennis
Entity Organization
Organization subpart 1 No
Enumeration date Mar 6th, 2007
Last updated Nov 29th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952431694 NPPES
Colorado MEDICAID 03664117
Colorado Other 0601573
Colorado Other 0601573

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