=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326867748
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIGID MAUREEN OFLANNIGAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2024
-----------------------------------------------------
Last Update Date | 10/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6900 S YOSEMITE ST
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80112-1418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-843-7600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3755 CANFIELD ST APT 203
-----------------------------------------------------
City | BOULDER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80301-4028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-317-5033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PHA.0024983
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------