Healthcare Provider Details

I. General information

NPI: 1619883527
Provider Name (Legal Business Name): LYNN MARIE POLLACK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 FOUNTAIN MESA RD
FOUNTAIN CO
80817-1532
US

IV. Provider business mailing address

1567 CHESHAM CIR
COLORADO SPRINGS CO
80907-8612
US

V. Phone/Fax

Practice location:
  • Phone: 719-382-0427
  • Fax:
Mailing address:
  • Phone: 719-382-0427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA0025628
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: