Healthcare Provider Details

I. General information

NPI: 1457838427
Provider Name (Legal Business Name): RHONDA HONG WONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 STOUT ST
DENVER CO
80205-2827
US

IV. Provider business mailing address

2111 CHAMPA ST
DENVER CO
80205-2529
US

V. Phone/Fax

Practice location:
  • Phone: 303-312-9873
  • Fax:
Mailing address:
  • Phone: 303-293-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77728
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number22667
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: