Healthcare Provider Details

I. General information

NPI: 1457696049
Provider Name (Legal Business Name): STEPHEN CHARLES MCCRUMB PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 TEJON ST
DENVER CO
80223-1221
US

IV. Provider business mailing address

6550 LOOKOUT RD
BOULDER CO
80301-3303
US

V. Phone/Fax

Practice location:
  • Phone: 303-698-3555
  • Fax:
Mailing address:
  • Phone: 303-475-4077
  • Fax: 303-530-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18056
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: