Healthcare Provider Details

I. General information

NPI: 1578488763
Provider Name (Legal Business Name): AMANI ABDERAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 S GARTRELL RD
AURORA CO
80016-4236
US

IV. Provider business mailing address

27922 E 10TH DR
AURORA CO
80018-1875
US

V. Phone/Fax

Practice location:
  • Phone: 303-209-2828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0025661
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: