Provider Demographics
NPI:1174923171
Name:RAZORBACK INDUSTRIES LLC
Entity type:Organization
Organization Name:RAZORBACK INDUSTRIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:970-978-4557
Mailing Address - Street 1:2914 67TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-7980
Mailing Address - Country:US
Mailing Address - Phone:970-978-4557
Mailing Address - Fax:970-978-4947
Practice Address - Street 1:2914 67TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-7980
Practice Address - Country:US
Practice Address - Phone:970-978-4557
Practice Address - Fax:970-978-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPDO.16800000X3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy