Healthcare Provider Details

I. General information

NPI: 1902311640
Provider Name (Legal Business Name): EVAN JOHN SLATER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 HALE PKWY STE 400
DENVER CO
80220-4051
US

IV. Provider business mailing address

4700 HALE PKWY STE 400
DENVER CO
80220-4051
US

V. Phone/Fax

Practice location:
  • Phone: 303-285-5085
  • Fax: 303-930-5517
Mailing address:
  • Phone: 303-285-5085
  • Fax: 303-930-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number16683
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: