Healthcare Provider Details

I. General information

NPI: 1891096566
Provider Name (Legal Business Name): ASHLEY LYNN RUUD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY LYNN VIRENE PHARMD

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR # B7500
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIR B7500
FORT CARSON CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 719-985-7496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16489
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.294788
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: