Wheatridge Drug Store LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1280000012 Issued in CO

Legal business name

WHEATRIDGE DRUG STORE LLC

Doing business as

Wheat Ridge Professional Pharmacy

Practice address

6650 W 38TH Ave
Wheat Ridge, CO 80033-4906

Phone

(303) 421-6111

Fax

(303) 431-8320

NPI assigned

Feb 24, 2015

Last updated

Oct 28, 2021By 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

Wendy Dilorenzo

Title

Office Manager

Phone

(303) 421-6111

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Wheat Ridge Professional Pharmacy Doing business as

Tax ID family

Wheat Ridge Professional Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wheatridge Drug Store LLC

  dba Wheat Ridge Professional Pharmacy

  • Community/Retail Pharmacy
  • Wheat Ridge, CO
  • NPI 1497214332
  NPD tax ID

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1811389174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334906",
            "telephone_number": "303-421-6111",
            "fax_number": "303-431-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334906",
            "telephone_number": "303-421-6111",
            "fax_number": "303-431-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATRIDGE DRUG STORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "DILORENZO",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-421-6111"
    },
    "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": "1280000012",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151932",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5080-3883",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheat Ridge Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wheatridge Drug Store LLC (Wheat Ridge Professional Pharmacy)
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• Christopher Sean White, CMT
• Desiree Giroux White, R.N.

• Community/Retail Pharmacy in Wheat Ridge, CO
• Providers in Wheat Ridge, 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 Oct 28, 2021; 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.