Provider Demographics
NPI:1437678315
Name:LORENZO APOTHECARY LLC
Entity Type:Organization
Organization Name:LORENZO APOTHECARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-522-0828
Mailing Address - Street 1:306 MAIN STREET
Mailing Address - Street 2:PO BOX 246
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-8075
Mailing Address - Country:US
Mailing Address - Phone:970-522-0828
Mailing Address - Fax:970-514-7909
Practice Address - Street 1:306 MAIN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751
Practice Address - Country:US
Practice Address - Phone:970-522-0828
Practice Address - Fax:970-522-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO142271835P0018X
CO333600000X333600000X
CO3336C0003X3336C0003X
CO3336C0004X3336C0004X
CO3336L0003X3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No333600000XSuppliersPharmacyGroup - Single Specialty
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy