Healthcare Provider Details

I. General information

NPI: 1093476145
Provider Name (Legal Business Name): RUDOLPH CARL STOTZ II PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5675 PECOS ST STE 100
DENVER CO
80221-6655
US

IV. Provider business mailing address

5675 PECOS ST STE 100
DENVER CO
80221-6655
US

V. Phone/Fax

Practice location:
  • Phone: 720-596-9500
  • Fax:
Mailing address:
  • Phone: 720-596-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23341
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: