Healthcare Provider Details

I. General information

NPI: 1982530952
Provider Name (Legal Business Name): LAUREN REYNOLDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE # 80045
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE # 80045
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 760-484-7664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0024897
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: