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General NPI Number Information
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NPI Number | 1154698355
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Entity Type | Individual
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Provider Name | MICHAEL AUGUSTYNIAK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 1811 W US HIGHWAY 50
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City | PUEBLO
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State | CO
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Zip | 81008-1646
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Country | US
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Telephone | 719-296-8007
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Fax | 719-296-8011
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Provider Business Mailing Address
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Address Line | 3645 RIALTO HTS
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8632
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Country | US
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Telephone | 719-337-2611
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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 | 18744
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 18744
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License Number State | CO
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