Healthcare Provider Details

I. General information

NPI: 1699680579
Provider Name (Legal Business Name): DAVID SCOTT BLACK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7914 WELLSHIRE CT
NIWOT CO
80503-7615
US

IV. Provider business mailing address

7914 WELLSHIRE CT
NIWOT CO
80503-7615
US

V. Phone/Fax

Practice location:
  • Phone: 303-902-5246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number1-11640
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: