Healthcare Provider Details

I. General information

NPI: 1013293851
Provider Name (Legal Business Name): ALEC THEIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

1700 WHEELING ST
AURORA CO
80045-7211
US

V. Phone/Fax

Practice location:
  • Phone: 860-616-0023
  • Fax: 860-616-2487
Mailing address:
  • Phone: 860-616-0023
  • Fax: 860-616-2487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPHA.0015581
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0010122
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: