Healthcare Provider Details

I. General information

NPI: 1467399907
Provider Name (Legal Business Name): MELANIE CARPENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 RIDGEGATE PKWY
LONE TREE CO
80124-5522
US

IV. Provider business mailing address

11182 CAMBRIDGE CT
PARKER CO
80138-7305
US

V. Phone/Fax

Practice location:
  • Phone: 720-225-1507
  • Fax:
Mailing address:
  • Phone: 720-225-1507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0021687
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: