Healthcare Provider Details

I. General information

NPI: 1295078467
Provider Name (Legal Business Name): KELLIE GEORGE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25701 E SMOKY HILL RD
AURORA CO
80016-1791
US

IV. Provider business mailing address

25701 E SMOKY HILL RD
AURORA CO
80016-1791
US

V. Phone/Fax

Practice location:
  • Phone: 303-615-2860
  • Fax: 303-615-2862
Mailing address:
  • Phone: 303-615-2860
  • Fax: 303-615-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number16135
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: