Provider Demographics
NPI:1477568830
Name:WHOLE HEALTH PHARMACY, INC.
Entity Type:Organization
Organization Name:WHOLE HEALTH PHARMACY, INC.
Other - Org Name:CLEARSPRING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-225-4446
Mailing Address - Street 1:8031 SOUTHPARK CIR STE C
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5724
Mailing Address - Country:US
Mailing Address - Phone:303-996-4401
Mailing Address - Fax:303-952-8060
Practice Address - Street 1:8031 SOUTHPARK CIR STE A
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5724
Practice Address - Country:US
Practice Address - Phone:303-795-4300
Practice Address - Fax:303-795-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CO7900000013336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0611562OtherNABP
CO45783730Medicaid
CO45783730Medicaid