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General NPI Number Information
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NPI Number | 1417514860
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Entity Type | Individual
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Provider Name | LACY BASSHAM COOK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 9400 RALSTON ROAD
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City | ARVADA
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State | CO
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Zip | 80002
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Country | US
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Telephone | 720-624-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 9400 RALSTON ROAD
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City | ARVADA
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State | CO
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Zip | 80002
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Country | US
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Telephone |
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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 | 19416
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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 | PD11635
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License Number State | AR
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