Ted Callahan, RPH
Individual provider Active NPI Pharmacist · Salida, CO
NPI 1629378229 · NPPES record last updated Oct 28, 2010
Key facts
- NPI
- 1629378229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14047 (CO)
- Practice address
- 232 G St
Salida, CO 81201-2019 - Phone
- (719) 539-6933
- Fax
- (719) 539-1538
- NPI assigned
- Oct 28, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14047 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14047 | CO | Yes |
Addresses
Primary practice location
232 G St
Salida, CO 81201-2019
Mailing address
232 G St
Salida, CO 81201-2019
Phone (719) 539-6933
Other providers in Salida, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2010. 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.