Healthcare Provider Details

I. General information

NPI: 1962393975
Provider Name (Legal Business Name): BETELEHEM GEBREMICHAEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 E QUINCY AVE APT J209
DENVER CO
80237-2483
US

IV. Provider business mailing address

8330 E QUINCY AVE APT J209
DENVER CO
80237-2483
US

V. Phone/Fax

Practice location:
  • Phone: 916-759-7814
  • Fax:
Mailing address:
  • Phone: 916-759-7814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0025228
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: