Healthcare Provider Details

I. General information

NPI: 1720014327
Provider Name (Legal Business Name): JANE ANDREA DUNBAR-SUWALSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE APOTHECARY AT WARDENBURG UNIVERSITY OF COLORADO CAMPUS BOX 119
BOULDER CO
80309-0001
US

IV. Provider business mailing address

THE APOTHECARY AT WARDENBURG UNIVERSITY OF COLORADO CAMPUS BOX 119
BOULDER CO
80309-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-492-8553
  • Fax: 303-492-4874
Mailing address:
  • Phone: 303-492-8553
  • Fax: 303-492-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14900
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number14900
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: