Most Relevant Information
Provider Data
| NPI Number: | 1003349093 |
| Provider Name: | JOHN GEORGE BREITNAUER RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PHA.0011791 |
Most Important Dates
| Enumeration Date: | 04/06/2017 |
| Last Updated: | 04/06/2017 |
Provider Practice Location
215 W MAIN ST
CEDARIDGE
CO
814131044
Practice Location Phone/Fax
| Phone: | 9708503161 |
| Fax: | 9708563021 |
Provider Mailing Location
PO BOX 1044
215 W MAIN ST
CEDAREDGE
CO
814131044
Provider Mailing Phone/Fax
| Phone: | 9708503161 |
| Fax: | 9708563021 |