Healthcare Provider Details

I. General information

NPI: 1891242228
Provider Name (Legal Business Name): JOSEPH KALIS PHARMD, BCOP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BOB PETERS GRV STE 202
COLORADO SPRINGS CO
80909-4533
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6568
  • Fax: 719-365-6317
Mailing address:
  • Phone: 970-624-2417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number19443
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number19443
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: