Organization · Type 2 NPI

Kaiser Foundation Health Plan of Colorado

Managed Care Organization Pharmacy · Longmont, CO

NPI number 1174698435 Active

Practice location

2345 Bent Way
Longmont, CO 80503-7614

Fax (303) 678-3302

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Managed Care Organization Pharmacy Primary	3336M0003X	800000019 (CO)

Managed Care Organization Pharmacy: A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.

65 other providers at this address

NPI record

NPI: 1174698435
Entity type: Organization (Type 2)
Issued: Nov 22, 2006
Last updated: Dec 31, 2025
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of Colorado

Other names

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Kaiser Permanente Longmont Pharmacy · doing business as
Kaiser Permanente Longmont Pharmacy · doing business as

Authorized official

Denese Clark
Regional Administrator
(303) 326-6717

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174698435

Kaiser Foundation Health Plan of Colorado's National Provider Identifier is 1174698435, issued on Nov 22, 2006. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Longmont, CO. The record was last updated on Dec 31, 2025.