Provider Demographics
NPI:1053498923
Name:PCA VENTURES OF COLORADO LLC
Entity Type:Organization
Organization Name:PCA VENTURES OF COLORADO LLC
Other - Org Name:HAYS MARKET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY MGR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:970-587-1128
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-0088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 JOHNSTOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-9073
Practice Address - Country:US
Practice Address - Phone:970-587-1128
Practice Address - Fax:970-587-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45785562Medicaid
0619481OtherOTHER ID NUMBER
0619481OtherOTHER ID NUMBER