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NPI Code Detail

MEDICARE: SHANE PATRICK O'CONNOR PHA

MEDICARE: SHANE PATRICK O'CONNOR PHA
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
1183500000XPharmacistPHA.0022895CO

General Provider Information

NPI Number : 1134779879
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE PATRICK O'CONNOR PHA
Provider Business Mailing Address
First Line : 801 16TH ST
Second Line :
City : DENVER
State : CO
Zip : 80202-3205
Country : US
Telephone Number : 303-571-5314
Fax Number :
Provider Business Practice Location Address
First Line : 801 16TH ST
Second Line :
City : DENVER
State : CO
Zip : 80202-3205
Country : US
Telephone Number : 303-571-5314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2019
Last Update Date : 09/15/2019

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Directions to “ SHANE PATRICK O'CONNOR PHA” Practice Location

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