Healthcare Provider Details

I. General information

NPI: 1669736005
Provider Name (Legal Business Name): DR. KORY M SCHARRINGHAUSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FT CARSON CO
80913-4613
US

IV. Provider business mailing address

1033 BURNING BUSH PT
MONUMENT CO
80132-8653
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-1062
  • Fax:
Mailing address:
  • Phone: 702-324-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17593
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: