Healthcare Provider Details

I. General information

NPI: 1043628142
Provider Name (Legal Business Name): JOHN LUGAFET
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 16TH ST
DENVER CO
80202-3204
US

IV. Provider business mailing address

1490 DELGANY ST APT 1008
DENVER CO
80202-6615
US

V. Phone/Fax

Practice location:
  • Phone: 405-203-6622
  • Fax: 405-203-6622
Mailing address:
  • Phone: 405-203-6622
  • Fax: 405-203-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20702
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: