Main Street Drug & Boutique
LBN: San Juan Pharmacy Monticello Inc.
Main Street Drug & Boutique is an health care organization with primary practice located at 140 S Main St , Monticello UT 84535. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
San Juan Pharmacy Monticello Inc. can be contacted via phone (435) 587-2302, or through Young, Tim via phone (435) 587-2302.
Contact Information
Primary practice address
140 S Main St
Monticello UT 84535
Phone: (435) 587-2302
Fax: (435) 587-3441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 127088-1703 | Utah |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1215144308 |
|---|---|
| LBN Legal business name | San Juan Pharmacy Monticello Inc. |
| DBA Doing business as | Main Street Drug & Boutique |
| Authorized official | Young, Tim |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 17th, 2007 |
| Last updated | Apr 13th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215144308 | NPPES |
| Colorado | MEDICAID | 88084876 | |
| Colorado | MEDICAID | 876000616040 | |
| Colorado | Other | 2107592 |
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