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General NPI Number Information
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NPI Number | 1528733037
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Entity Type | Individual
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Provider Name | ELINA GONNOV PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 1501 S POTOMAC ST
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City | AURORA
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State | CO
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Zip | 80012-5411
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Country | US
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Telephone | 303-695-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 24568 E ADA AVE
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City | AURORA
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State | CO
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Zip | 80018-6166
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 20873
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License Number State | CO
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