Healthcare Provider Details

I. General information

NPI: 1861623563
Provider Name (Legal Business Name): MIRANDA L COLE PHARMD, BCPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 INDEPENDENCE ST
WHEAT RIDGE CO
80033-6715
US

IV. Provider business mailing address

4851 INDEPENDENCE ST
WHEAT RIDGE CO
80033-6715
US

V. Phone/Fax

Practice location:
  • Phone: 303-432-5181
  • Fax:
Mailing address:
  • Phone: 303-432-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number052552
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0024758
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number052552
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0024758
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number052552
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPHA.0024758
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: