Healthcare Provider Details

I. General information

NPI: 1588287098
Provider Name (Legal Business Name): PIA MAE SANGALANG MORENO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
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: 303-293-2220
  • Fax: 303-296-8826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA0025518
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: