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NPI Code Detail

MEDICARE: STEPHANIE J DAVIS RPH

MEDICARE: STEPHANIE J DAVIS 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
1183500000XPharmacist14720CO

General Provider Information

NPI Number : 1154764736
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE J DAVIS RPH
Provider Business Mailing Address
First Line : 1970 ORCHARD AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-1303
Country : US
Telephone Number : 303-817-8336
Fax Number :
Provider Business Practice Location Address
First Line : 2870 S COLORADO BLVD
Second Line :
City : DENVER
State : CO
Zip : 80222-6618
Country : US
Telephone Number : 303-757-8347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2013
Last Update Date : 04/12/2013

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