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General NPI Number Information
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NPI Number | 1740157866
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Entity Type | Organization
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Legal Business Name | 2ND HOME PHARMACY - EVANS LLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 6880 E EVANS AVE
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City | DENVER
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State | CO
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Zip | 80224-2330
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Country | US
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Telephone | 303-999-7763
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Fax | 303-999-7763
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Provider Business Mailing Address
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Address Line | 3131 S VAUGHN WAY STE 600
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City | DENVER
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State | CO
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Zip | 80014-3508
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Country | US
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Telephone | 303-999-7763
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HANEEN M OMAR
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Credential | MRS
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Telephone | 303-999-7763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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