Healthcare Provider Details

I. General information

NPI: 1639459209
Provider Name (Legal Business Name): RICHARD SAXON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 S BOULDER RD
LOUISVILLE CO
80027-1328
US

IV. Provider business mailing address

1109 CENTAUR CIR
LAFAYETTE CO
80026-1444
US

V. Phone/Fax

Practice location:
  • Phone: 303-666-6061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10792
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: