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NPI Code Detail

MEDICARE: ADVANCED CARE PROF PHCY PC

MEDICARE: ADVANCED CARE PROF PHCY PC
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
1333600000XPharmacyPDO636CO
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20619758OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1164594941
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED CARE PROF PHCY PC
Provider Business Mailing Address
First Line : 2789 W ALAMEDA AVE
Second Line : STE 2
City : DENVER
State : CO
Zip : 80219-3042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2789 W ALAMEDA AVE
Second Line : STE 2
City : DENVER
State : CO
Zip : 80219-3042
Country : US
Telephone Number : 303-237-6164
Fax Number : 303-237-6165
Authorized Official
Title or Position : CHIEF PHARMACIST
Name : TRIN HUA
Credential : RPH
Telephone Number : 303-237-6164
Provider Enumeration Date : 11/15/2006
Last Update Date : 09/11/2025

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Directions to “ADVANCED CARE PROF PHCY PC ” Practice Location

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