Healthcare Provider Details

I. General information

NPI: 1629914809
Provider Name (Legal Business Name): RAQUEL DE OLIVEIRA EDISBURY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 CROSS BRIDGE CIR
CASTLE ROCK CO
80108-9526
US

IV. Provider business mailing address

6820 CROSS BRIDGE CIR
CASTLE ROCK CO
80108-9526
US

V. Phone/Fax

Practice location:
  • Phone: 720-633-2887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22898
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: