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General NPI Number Information
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NPI Number | 1184432320
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Entity Type | Individual
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Provider Name | TEENA MATHEW
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 4851 INDEPENDENCE ST
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-6715
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Country | US
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Telephone | 303-432-5725
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Fax |
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Provider Business Mailing Address
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Address Line | 8708 E 105TH DR
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City | COMMERCE CITY
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State | CO
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Zip | 80640-7528
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Country | US
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Telephone | 720-926-5115
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PHAT.0017872
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License Number State | CO
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