Healthcare Provider Details

I. General information

NPI: 1023534120
Provider Name (Legal Business Name): IAN HOLT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 HWY 287
BROOMFIELD CO
80020-7001
US

IV. Provider business mailing address

1150 HWY 287
BROOMFIELD CO
80020-7001
US

V. Phone/Fax

Practice location:
  • Phone: 303-439-9040
  • Fax:
Mailing address:
  • Phone: 303-439-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0010262
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number019490
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0023147
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0023147
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: