Healthcare Provider Details

I. General information

NPI: 1841632700
Provider Name (Legal Business Name): ALLICIA WILLIAMS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2013
Last Update Date: 04/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 13TH ST
BOULDER CO
80304-4104
US

IV. Provider business mailing address

1345 PLAZA CT N 1A
LAFAYETTE CO
80026-3531
US

V. Phone/Fax

Practice location:
  • Phone: 303-449-6050
  • Fax: 720-206-0434
Mailing address:
  • Phone: 303-665-3036
  • Fax: 720-206-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19530
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: