MEDICARE: THOMAS REPINE II RPH

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	15521	CO

General Provider Information

NPI Number	:	1801230214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS REPINE II RPH

Provider Business Mailing Address
First Line	:	9731 W 58TH AVE
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80002-2016
Country	:	US
Telephone Number	:	303-421-1200
Fax Number	:	303-403-2881

Provider Business Practice Location Address
First Line	:	9731 W 58TH AVE
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80002-2016
Country	:	US
Telephone Number	:	303-421-1200
Fax Number	:	303-403-2881

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

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	04/29/2013

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Directions to “ THOMAS REPINE II RPH” Practice Location

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