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Contact Information

CEDAREDGE PHARMACY INC.
215 W. MAIN ST
CEDAREDGE, CO81413
 Phone: 970-856-3161
 Fax: 970-856-3021
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CEDAREDGE PHARMACY INC.

NPI # 1194897447
LBN Legal business name CEDAREDGE PHARMACY INC.
Authorized official JOHN BREITNAUER - (OWNER/PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/14/2006
Last updated 02/14/2017 - About 9 years ago
Identifiers
CO License # 20-1
CO License # PDOI200000001
CO Medicaid 03000494
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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