Healthcare Provider Details

I. General information

NPI: 1811330350
Provider Name (Legal Business Name): CHRIS KOTSCHWAR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 W BAPTIST RD
COLORADO SPRINGS CO
80921-2402
US

IV. Provider business mailing address

1070 W BAPTIST RD
COLORADO SPRINGS CO
80921-2402
US

V. Phone/Fax

Practice location:
  • Phone: 719-488-2988
  • Fax: 719-488-0259
Mailing address:
  • Phone: 719-488-2988
  • Fax: 719-488-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16806
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: