Healthcare Provider Details

I. General information

NPI: 1871029058
Provider Name (Legal Business Name): TAYANA STEFANOVIC PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 E 9TH AVE
DENVER CO
80218-4802
US

IV. Provider business mailing address

1155 E 9TH AVE
DENVER CO
80218-4802
US

V. Phone/Fax

Practice location:
  • Phone: 303-832-5298
  • Fax:
Mailing address:
  • Phone: 303-832-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50413
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: