MEDICARE: EMILY ROUSSEAU PHARMD

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
1	183500000X	Pharmacist	PHA.0023673	CO

General Provider Information

NPI Number	:	1104786680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ROUSSEAU PHARMD

Provider Business Mailing Address
First Line	:	755 E 19TH AVE APT 219
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-5523
Country	:	US
Telephone Number	:	314-518-2722
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 JACKSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1923
Country	:	US
Telephone Number	:	303-398-1355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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Directions to “ EMILY ROUSSEAU PHARMD” Practice Location

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