=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568330280
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELINE ANDEL GOLDWIRE PHARMD, BCPS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2025
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2719 S DEPEW ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80227-4106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-244-0012
-----------------------------------------------------
Fax | 720-244-0012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2719 S DEPEW ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80227-4106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-244-0012
-----------------------------------------------------
Fax | 720-244-0012
-----------------------------------------------------
=====================================================
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.0018998
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------