Poudre Drug Company

Primary specialty

PharmacyTaxonomy code 333600000X

License

440000009 Issued in CO

Legal business name

POUDRE DRUG COMPANY

Practice address

1221 East Elizabeth
Suite 1
Fort Collins, CO 80524-4066

Phone

(970) 484-2777

Fax

(970) 407-0449

NPI assigned

Feb 22, 2007

Last updated

Jul 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Walter Reed, RPH

Title

Owner Pharmacist

Phone

(970) 484-2777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1306971171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 EAST ELIZABETH",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244066",
            "telephone_number": "970-484-2777",
            "fax_number": "970-407-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 EAST ELIZABETH",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244066",
            "telephone_number": "970-484-2777",
            "fax_number": "970-407-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "970-484-2777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CO",
            "license": "440000009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03698842",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Poudre School District R-1
• Poudre Valley Eyecare LLC
• Poudre Valley Health Care Inc

• Pharmacy in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.