Provider Demographics
NPI:1215639661
Name:SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Entity type:Organization
Organization Name:SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-284-1004
Mailing Address - Street 1:500 ELDORADO BLVD STE 4300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3564
Mailing Address - Country:US
Mailing Address - Phone:303-272-0566
Mailing Address - Fax:303-272-0390
Practice Address - Street 1:602 HENRY CHAPPLE ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-1874
Practice Address - Country:US
Practice Address - Phone:406-237-3560
Practice Address - Fax:406-206-5794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy