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General NPI Number Information
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NPI Number | 1164588547
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Entity Type | Individual
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Provider Name | PAUL MARVIN ATHEY PHARM.D.,RPH
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 3570 HARTSEL DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-4165
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Country | US
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Telephone | 719-590-7515
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Fax |
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Provider Business Mailing Address
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Address Line | 6556 MYRTLE CREEK DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80927-4097
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Country | US
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Telephone | 402-578-9629
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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 | 13955
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9609
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License Number State | NE
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