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NPI Code Detail

MEDICARE: LISA EILEEN SHAVER PHARM.D.

MEDICARE: LISA EILEEN SHAVER PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist14821CO

General Provider Information

NPI Number : 1124387063
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA EILEEN SHAVER PHARM.D.
Provider Business Mailing Address
First Line : 12656 W MISSISSIPPI AVE
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-3521
Country : US
Telephone Number : 303-949-2561
Fax Number :
Provider Business Practice Location Address
First Line : 12880 W ALAMEDA PKWY
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-3115
Country : US
Telephone Number : 303-457-5145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2012
Last Update Date : 05/13/2012

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