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JIMMY LEE CASSITY RPH

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1790902666

Individual Registrant:
 JIMMY LEE CASSITY RPH
Gender: M
Not Sole Proprietor

Location and contact information for practice:
222 SOLAR AVE  MONTE VISTA, CO 81144-1066 US
Tel: 719-852-9894  Fax: --

Contact information for business:
PO BOX 916  ALAMOSA, CO 81101-0916 US
Tel: 719-588-4377  Fax: --

Registration Information:
NPI: 1790902666
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CO14302

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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