MEDICARE: RAYNETTE JUNE ADKINS I

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	13590	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13590	OTHER	CO	PHARMACIST

General Provider Information

NPI Number	:	1346239936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYNETTE JUNE ADKINS I

Provider Business Mailing Address
First Line	:	342 MELODY DR
Second Line	:
City	:	NORTHGLENN
State	:	CO
Zip	:	80260-5543
Country	:	US
Telephone Number	:	303-450-0648
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 DELAWARE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4532
Country	:	US
Telephone Number	:	303-436-7776
Fax Number	:	303-436-8148

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	07/08/2007

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