1043225402 NPI number — WHOLE HEALTH PHARMACY INC

Table of content: NANCY ANN MACE APRN (NPI 1285638940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043225402 NPI number — WHOLE HEALTH PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHOLE HEALTH PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043225402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8031 SOUTHPARK CIR STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80120-5724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-996-4401
Provider Business Mailing Address Fax Number:
303-952-8060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80206-4657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-333-2010
Provider Business Practice Location Address Fax Number:
303-333-2208
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-225-4446

Provider Taxonomy Codes

  • Taxonomy code: 3336C0004X , with the licence number:  432 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 432 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0617235 . This is a "NABP" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 62801082 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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