Healthcare Provider Details

I. General information

NPI: 1821375296
Provider Name (Legal Business Name): MARY LOUISE ROLDAN CRABTREE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2011
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14967 CANDELAS PKWY
ARVADA CO
80007-7710
US

IV. Provider business mailing address

9170 W 88TH CIR
WESTMINSTER CO
80021-4471
US

V. Phone/Fax

Practice location:
  • Phone: 720-907-6788
  • Fax: 303-416-8422
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17740
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: