Healthcare Provider Details

I. General information

NPI: 1982980561
Provider Name (Legal Business Name): PATRICK ROETS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 FEDERAL BLVD
DENVER CO
80211-3741
US

IV. Provider business mailing address

2975 FEDERAL BLVD
DENVER CO
80211-3741
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-8911
  • Fax:
Mailing address:
  • Phone: 303-433-8911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18824
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: