Healthcare Provider Details

I. General information

NPI: 1760435010
Provider Name (Legal Business Name): JOEL TRENT GILES PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 TEJON ST
DENVER CO
80223-1221
US

IV. Provider business mailing address

65 TEJON ST
DENVER CO
80223-1221
US

V. Phone/Fax

Practice location:
  • Phone: 303-698-3537
  • Fax: 303-778-2774
Mailing address:
  • Phone: 303-698-3537
  • Fax: 303-778-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number16257
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: