Healthcare Provider Details

I. General information

NPI: 1447831193
Provider Name (Legal Business Name): TREVOR BEUTEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12850 E MONTVIEW BLVD
AURORA CO
80045-2605
US

IV. Provider business mailing address

656 N CEDAR ST APT 258
SPOKANE WA
99201-1916
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-2882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP9075
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: