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General NPI Number Information
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NPI Number | 1023796745
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Entity Type | Individual
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Provider Name | TANYA MUSCATELLO DAVIS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 5190 W 120TH AVE
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City | WESTMINSTER
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State | CO
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Zip | 80020-3332
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Country | US
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Telephone | 303-410-1105
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Fax |
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Provider Business Mailing Address
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Address Line | 835 E 17TH AVE
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City | LONGMONT
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State | CO
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Zip | 80504-3003
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Country | US
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Telephone | 303-651-7468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0024451
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License Number State | CO
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