MEDICARE: JIYANG PHELPS

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	22596	CO
2	183500000X	Pharmacist	PS51110	FL

General Provider Information

NPI Number	:	1356704126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIYANG PHELPS

Provider Business Mailing Address
First Line	:	4142 AUSTIN BLUFFS PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-2928
Country	:	US
Telephone Number	:	719-244-9783
Fax Number	:

Provider Business Practice Location Address
First Line	:	4142 AUSTIN BLUFFS PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-2928
Country	:	US
Telephone Number	:	719-244-9783
Fax Number	:

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	11/20/2025

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Directions to “ JIYANG PHELPS ” Practice Location

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