Provider Demographics
NPI:1871638841
Name:DILLON COMPANY
Entity type:Organization
Organization Name:DILLON COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:WOOLF
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-762-4672
Mailing Address - Street 1:8200 S HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-4012
Mailing Address - Country:US
Mailing Address - Phone:303-779-4242
Mailing Address - Fax:303-843-6021
Practice Address - Street 1:8200 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4012
Practice Address - Country:US
Practice Address - Phone:303-779-4242
Practice Address - Fax:303-843-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79-73336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03485992Medicaid
94523OtherMEDICARE MASS IMMUNIZER
0610267OtherNCPDP NUMBER
0610267OtherNCPDP NUMBER