John D. Kutzko, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHA.0019440 Issued in CO

Practice address

Selah Mountain Pharmacy
426 Pagosa Street
Pagosa Springs, CO 81147

Phone

(970) 264-0126

Fax

(970) 507-6111

NPI assigned

Jul 13, 2017

Last updated

Jun 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Selah Mountain Pharmacy LLC

  dba Selah Mountain Pharmacy

  • Community/Retail Pharmacy
  • Pagosa Springs, CO
  • NPI 1497211379
  NPD Authorized official
• Petra Pharmacy Services, Inc.

  dba Pagosa Specialty Pharmacy

  • Community/Retail Pharmacy
  • Pagosa Springs, CO
  • NPI 1396144200
  Authorized official Same address or phone
• Astro RX, LLC

  dba Astro Rx

  • Community/Retail Pharmacy
  • Spring, TX
  • NPI 1144657206
  NPD (past)

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1205358918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 623",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811470623",
            "telephone_number": "941-321-8067",
            "fax_number": "970-507-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SELAH MOUNTAIN PHARMACY",
            "address_2": "426 PAGOSA STREET",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "81147",
            "telephone_number": "970-264-0126",
            "fax_number": "970-507-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZKO",
        "first_name": "JOHN",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA.0019440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF PHARMACY",
            "identifier": "PS21744",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO BOARD OF PHARMACY",
            "identifier": "RP00007870",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHARMACY",
            "identifier": "62239",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO BOARD OF PHARMACY",
            "identifier": "PHA.0019440",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faith Koehler
• Jennifer Marie Krick, LCSW
• Donald E. Kring Jr., D.O.
• Susan Carol Kuhns, NP
• Nicholas Brian Kurz, DO
• Robert A Lambert, MD
• Sherry Lane, RDH
• Lorene Lawrence, LMMT, RYT, CAP
• Pascale D Lecuire, PA
• Leo Milner

• Pharmacist in Pagosa Springs, CO
• Providers in Pagosa Springs, CO by specialty
• Pharmacist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.