Kremmling Mercantile LLC
Organization Active NPI Community/Retail Pharmacy · Kremmling, CO
NPI 1376608562 · NPPES record last updated Jan 18, 2017
Key facts
- NPI
- 1376608562
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 623 (CO)
- Legal business name
- KREMMLING MERCANTILE LLC
- Practice address
- 101 Martin Way
Kremmling, CO 80459 - Phone
- (970) 724-3205
- Fax
- (970) 724-3225
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Karen Hammer, RPH
- Title
- Controller
- Phone
- (970) 724-3400
Practitioners 1
-
Paul Soderberg, RPH
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 623 | CO | Yes |
Addresses
Primary practice location
101 Martin Way
Kremmling, CO 80459
Mailing address
PO Box 1600
Kremmling, CO 80459-1600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2003836 | Other | PK | |
| 28929039 | Medicaid | CO |
Other names
- KREMMLING MERCANTILE
Other providers in Kremmling, CO
- Kremmling Memorial Hospital District
- Kremmling Memorial Hospital District
- Kremmling Memorial Hospital District
- Kremmling Memorial Hospital District
- Kremmling Memorial Hospital District
- Michelle Victoria Licha
- Kellie Logue
- Michelle Lee Lupica
- Stephanie Collins Miller
- Meghan Rochelle Mont
All providers in Kremmling, CO · Community/Retail Pharmacy in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.