=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619785821
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SCHYLER KNOLL PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2024
-----------------------------------------------------
Last Update Date | 12/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1375 E SOUTH BOULDER RD
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027-2344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-673-1818
-----------------------------------------------------
Fax | 303-673-1981
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1375 E SOUTH BOULDER RD
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027-2344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-673-1818
-----------------------------------------------------
Fax | 303-673-1981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | PHA.0025061
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------