Provider Demographics
NPI:1457478992
Name:TOBIN DRUG STORES INC
Entity Type:Organization
Organization Name:TOBIN DRUG STORES INC
Other - Org Name:PENCOL COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:303-388-3613
Mailing Address - Street 1:1325 S COLORADO BLVD
Mailing Address - Street 2:SUITE B-024
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3303
Mailing Address - Country:US
Mailing Address - Phone:303-388-3613
Mailing Address - Fax:303-388-6182
Practice Address - Street 1:1325 S COLORADO BLVD
Practice Address - Street 2:SUITE B-024
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:303-388-3613
Practice Address - Fax:303-388-6182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1541835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty