MEDICARE: DR. SUZANNE J KASIM PHARM.D. CGP

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	RPH 43204	CA

General Provider Information

NPI Number	:	1316942188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE J KASIM PHARM.D. CGP

Provider Business Mailing Address
First Line	:	10687 CEDARCREST CIR
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80130-8939
Country	:	US
Telephone Number	:	303-399-8020
Fax Number	:	303-906-7512

Provider Business Practice Location Address
First Line	:	1055 CLERMONT ST
Second Line	:	HBPC, BUILDING 4
City	:	DENVER
State	:	CO
Zip	:	80220-3808
Country	:	US
Telephone Number	:	303-399-8020
Fax Number	:	303-906-7512

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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