Bonnie Brae Drugstore LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PDO-816 Issued in CO

Legal business name

BONNIE BRAE DRUGSTORE LLC

Practice address

2700 E Louisiana Ave Apt 102
Denver, CO 80210-2009

Phone

(303) 722-7892

Fax

(720) 223-7269

NPI assigned

Feb 23, 2011

Organization subpart

No

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

Authorized official

Name

Benjamin LagerNPI 1770883795

Title

Owner/Manager

Phone

(303) 722-7892

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Bonnie Brae Drugstore Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Lager, RPH

  • Pharmacist
  • Denver, CO
  • NPI 1770883795
  NPD (past) Authorized official

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1578860805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E LOUISIANA AVE APT 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802102009",
            "telephone_number": "303-722-7892",
            "fax_number": "720-223-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E LOUISIANA AVE APT 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802102009",
            "telephone_number": "303-722-7892",
            "fax_number": "720-223-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE BRAE DRUGSTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "LAGER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "303-722-7892"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "PDO-816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54301378",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0622022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonnie Brae Drugstore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darcy Nicole Bonnema, MA, CCC-SLP
• Abria Diana Bonner, MD
• Caitlin Bonner
• Paula A Bonner
• Bonnie Brae Counseling PLLC
• Bonnie Mucklow
• Kathleen Bonnington, LPC
• Stephanie Bono, PSYD
• Erin Elizabeth Bonthron
• Jeffrey Allen Bontrager, M.D.

• Community/Retail Pharmacy in Denver, CO
• Providers in Denver, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.