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NPI Code Detail

MEDICARE: MRS. JULIE KAY CROCFER RPH

MEDICARE: MRS. JULIE KAY CROCFER RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist15716CO

General Provider Information

NPI Number : 1104489855
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE KAY CROCFER RPH
Provider Business Mailing Address
First Line : 6310 S US HIGHWAY 85-87
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1006
Country : US
Telephone Number : 719-391-1505
Fax Number : 719-390-8987
Provider Business Practice Location Address
First Line : 6310 S US HIGHWAY 85-87
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1006
Country : US
Telephone Number : 719-391-1505
Fax Number : 719-390-8987
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2019
Last Update Date : 04/18/2019

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