Provider Demographics
NPI:1811641368
Name:APEX PHARMACY LLC
Entity type:Organization
Organization Name:APEX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAMAWIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:303-479-3864
Mailing Address - Street 1:12597 E MISSISSIPPI AVE UNIT 300
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3460
Mailing Address - Country:US
Mailing Address - Phone:303-479-3864
Mailing Address - Fax:303-479-3863
Practice Address - Street 1:12597 E MISSISSIPPI AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3460
Practice Address - Country:US
Practice Address - Phone:303-479-3864
Practice Address - Fax:303-479-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy