MEDICARE: DR. ADAM STILL 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	18025	CO

General Provider Information

NPI Number	:	1518243161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM STILL PHARMD

Provider Business Mailing Address
First Line	:	10390 FEDERAL BLVD
Second Line	:
City	:	FEDERAL HEIGHTS
State	:	CO
Zip	:	80260-6101
Country	:	US
Telephone Number	:	720-887-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	10390 FEDERAL BLVD
Second Line	:
City	:	FEDERAL HEIGHTS
State	:	CO
Zip	:	80260-6101
Country	:	US
Telephone Number	:	720-887-9145
Fax Number	:

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

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	10/27/2011

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