Healthcare Provider Details

I. General information

NPI: 1184141681
Provider Name (Legal Business Name): CAMERON PHILLIPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 TEJON ST
DENVER CO
80223-1221
US

IV. Provider business mailing address

4663 W OBERLIN PL
DENVER CO
80236-3201
US

V. Phone/Fax

Practice location:
  • Phone: 661-607-6699
  • Fax:
Mailing address:
  • Phone: 661-607-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0021928
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: