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General NPI Number Information
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NPI Number | 1699053439
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Entity Type | Individual
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Provider Name | CASEY SUPERCHI PATTERSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 9229 E LINCOLN AVE
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City | LONE TREE
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State | CO
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Zip | 80124-5502
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Country | US
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Telephone | 36-499-7493
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Fax | 970-870-1684
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Provider Business Mailing Address
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Address Line | 9229 E LINCOLN AVE
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City | LONE TREE
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State | CO
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Zip | 80124-5502
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Country | US
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Telephone | 36-499-7493
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Fax | 970-870-1684
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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 | 19149
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License Number State | CO
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