MEDICARE: DENISE MICHELLE EMMERT 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	18717	CO

General Provider Information

NPI Number	:	1598074296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE MICHELLE EMMERT PHARMD

Provider Business Mailing Address
First Line	:	2172 S TRENTON WAY APT 7-103
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5399
Country	:	US
Telephone Number	:	402-215-6812
Fax Number	:

Provider Business Practice Location Address
First Line	:	11907 W ALAMEDA PKWY
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2706
Country	:	US
Telephone Number	:	303-985-4466
Fax Number	:

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	09/29/2010

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