Healthcare Provider Details

I. General information

NPI: 1124881081
Provider Name (Legal Business Name): NICHOLAS ANTHONY SAKALA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 EAGLE DR
LOVELAND CO
80537-8058
US

IV. Provider business mailing address

1275 EAGLE DR
LOVELAND CO
80537-8058
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-4121
  • Fax:
Mailing address:
  • Phone: 970-663-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0024639
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number0024639
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: