Bonfiglio Drug, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

94-01 Issued in CO

Legal business name

BONFIGLIO DRUG, INC

Practice address

118 West Main Street
Oak Creek, CO 80467

Phone

(970) 736-2377

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

David R Bonfiglio

Title

President

Phone

(970) 736-2377

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1700968641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748",
            "city": "OAK CREEK",
            "state": "CO",
            "postal_code": "804670748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 WEST MAIN STREET",
            "city": "OAK CREEK",
            "state": "CO",
            "postal_code": "80467",
            "telephone_number": "970-736-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONFIGLIO DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "BONFIGLIO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-736-2377"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "94-01",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CO",
            "license": "94-01",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0605444",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03002532",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Karen Anderson, OTD, OTR/L
• Linda B Casner, NP
• Denise Maureen Clark, MD
• Enlighten Minds LLC
• Mary Suzanne Hamill, DH
• Angelina Marie Henry, R.D.H.

• Community/Retail Pharmacy in Oak Creek, CO
• Providers in Oak Creek, 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 Jun 11, 2018; 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.