Kmart Phramacy

NPI #1891159976 in Pueblo, Colorado

Provider Information

NPI Number: 1891159976
Entity Type: Organization
Organization Name: Kmart Phramacy
Primary Specialty: Point of Service
Enumeration Date: Apr 5, 2016
Last Updated: Apr 5, 2016

Practice Location

Address: 3415 N ELIZABETH ST
City: Pueblo
State: Colorado
ZIP Code: 81008-1156
Phone: (719) 545-0707

Authorized Official

Name: MR. SEYED ABOTALEB ALAVI, RPH
Title: PHARMACIST
Phone: (719) 568-0470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Point of Service	305S00000X	Primary

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