Provider Demographics
NPI:1821024258
Name:THE APOTHECARY
Entity Type:Organization
Organization Name:THE APOTHECARY
Other - Org Name:UNIVERSITY OF COLORADO SCHOOL OF PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:303-492-8553
Mailing Address - Street 1:WARDENBURG HEALTH CENTER
Mailing Address - Street 2:CAMPUS BOX 119
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80309-0001
Mailing Address - Country:US
Mailing Address - Phone:303-492-8553
Mailing Address - Fax:
Practice Address - Street 1:WARDENBURG HEALTH CENTER
Practice Address - Street 2:CAMPUS BOX 119
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-0001
Practice Address - Country:US
Practice Address - Phone:303-492-8553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9900000203336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy