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General NPI Number Information
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NPI Number | 1639315641
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Entity Type | Organization
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Legal Business Name | AVISTA ADVENTIST HOSPITAL PHARMACY
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 100 HEALTH PARK DR
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City | LOUISVILLE
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State | CO
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Zip | 80027-9583
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Country | US
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Telephone | 303-673-1234
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Fax | 303-673-1237
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Provider Business Mailing Address
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Address Line | 100 HEALTH PARK DR
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City | LOUISVILLE
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State | CO
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Zip | 80027-9583
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Country | US
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Telephone | 303-673-1234
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Fax | 303-673-1237
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | NANETTE TINKER
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Credential | RPH
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Telephone | 303-673-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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