MEDICARE: I JOELAH LANDMAN

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
1	183500000X	Pharmacist	12092	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558926790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	I JOELAH LANDMAN

Provider Business Mailing Address
First Line	:	5990 DAHLIA ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-3708
Country	:	US
Telephone Number	:	303-287-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	5990 DAHLIA ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-3708
Country	:	US
Telephone Number	:	303-287-0909
Fax Number	:	303-287-2727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2019
Last Update Date	:	05/02/2019

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Directions to “ I JOELAH LANDMAN ” Practice Location

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