MEDICARE: RILEY MITCHELL PHARMD

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	PHA.0024519	CO

General Provider Information

NPI Number	:	1508649260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY MITCHELL PHARMD

Provider Business Mailing Address
First Line	:	18243 E DORADO AVE
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80015-3082
Country	:	US
Telephone Number	:	303-668-4892
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 N MURRAY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-3405
Country	:	US
Telephone Number	:	719-596-1401
Fax Number	:

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

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	09/19/2023

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Directions to “ RILEY MITCHELL PHARMD” Practice Location

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