Healthcare Provider Details

I. General information

NPI: 1205765112
Provider Name (Legal Business Name): PRESTON E CANUL PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15310 E 104TH AVE
COMMERCE CITY CO
80022-8607
US

IV. Provider business mailing address

15310 E 104TH AVE
COMMERCE CITY CO
80022-8607
US

V. Phone/Fax

Practice location:
  • Phone: 303-928-4084
  • Fax:
Mailing address:
  • Phone: 303-928-4084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0023037
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: