Healthcare Provider Details

I. General information

NPI: 1033008271
Provider Name (Legal Business Name): MARC DERICK CATBAGAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 SILVERSTONE DR
FREDERICK CO
80504-6066
US

IV. Provider business mailing address

5801 SILVERSTONE DR
FREDERICK CO
80504-6066
US

V. Phone/Fax

Practice location:
  • Phone: 303-327-1100
  • Fax:
Mailing address:
  • Phone: 303-327-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2008692
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25322
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number25322
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: