Individual provider Active NPI

Mike Epstein

  • Long Term Care Pharmacy
  • Colorado Springs, CO
National Provider Identifier
1194002527
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
13092 Issued in CO
Practice address
4162 E Bijou St
Colorado Springs, CO 80909-6824
Phone
(719) 457-6377
NPI assigned
Nov 14, 2011
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 13092 CO Primary

Addresses

Primary practice location

4162 E Bijou St
Colorado Springs, CO 80909-6824

Mailing address

4162 E Bijou St
Colorado Springs, CO 80909-6824
Phone (719) 457-6377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13092COMDLong Term Care Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pharmacy Group LLC Long Term Care Pharmacy Current Accepting new patients
Founders RX LLC Long Term Care Pharmacy CurrentSince May 21, 2023 Accepting new patients
Premier Pharmacy Group LLC Long Term Care Pharmacy CurrentSince Jan 31, 2021 Accepting new patients

Locations

101 S Union Blvd
Colorado Springs, CO 80910
Phone (719) 634-3711

4162 E Bijou St
Colorado Springs, CO 80909
Phone (469) 636-5055

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1194002527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4162 E BIJOU ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096824",
            "telephone_number": "719-457-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4162 E BIJOU ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096824",
            "telephone_number": "719-457-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "MIKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CO",
            "license": "13092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.