Provider Demographics
NPI:1659899227
Name:VEATCH PHARMACY SOLUTIONS
Entity Type:Organization
Organization Name:VEATCH PHARMACY SOLUTIONS
Other - Org Name:THE APOTHECARY SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:VEATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-864-2100
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NUCLA
Mailing Address - State:CO
Mailing Address - Zip Code:81424-0429
Mailing Address - Country:US
Mailing Address - Phone:970-864-2100
Mailing Address - Fax:970-864-7926
Practice Address - Street 1:480 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NUCLA
Practice Address - State:CO
Practice Address - Zip Code:81424
Practice Address - Country:US
Practice Address - Phone:970-864-2100
Practice Address - Fax:970-864-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
CO16800001573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2171595OtherPK
CO900160308Medicaid