Healthcare Provider Details

I. General information

NPI: 1972712487
Provider Name (Legal Business Name): PAULA S ALEXANDER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAULA S MARTILLARO

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3292 PEORIA ST
AURORA CO
80010-1517
US

IV. Provider business mailing address

2255 S ONEIDA ST
DENVER CO
80224-2522
US

V. Phone/Fax

Practice location:
  • Phone: 303-343-6642
  • Fax: 303-343-6932
Mailing address:
  • Phone: 303-761-1977
  • Fax: 303-467-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15241
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: