Legal Business Name
Pagosa Health
Also Known As
Pagosa Health
NPI Number
1043652654
NPI Type
Organization
Enumeration Date
07/24/2013
Specialties
(Taxonomies)Code
3336M0002X
333600000X
3336S0011X
Primary Taxonomy
Yes
No
No
Licenses
State
Indiana
License Number
60006342A
Contact
Information
Purpose
Mailing
Location
Address
62 DOUGHTY RD STE 4
62 DOUGHTY RD STE 4
City
Lawrenceburg
Lawrenceburg
State
IN
IN
Postal Code
47025-2951
47025-2951
Country
US
US
Telephone Number
(888) 821-9982
(888) 821-9982
Authorized Official
Name
Ronald Koehler
Title or Position
DIRECTOR OF PHARMACY OPERATION
Telephone Number
(859) 638-2795
Identifiers
Identifier
2141276
Identifier State
Unknown
Identifier Issuer
PK
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/24/2013