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NPI Code Detail

MEDICARE: KIDANE TEKLEHAIMANOT RPH

MEDICARE: KIDANE TEKLEHAIMANOT RPH
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
1183500000XPharmacist15291CO

General Provider Information

NPI Number : 1619314077
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIDANE TEKLEHAIMANOT RPH
Provider Business Mailing Address
First Line : 2810 QUEBEC ST
Second Line : PHARMACY
City : DENVER
State : CO
Zip : 80207-2900
Country : US
Telephone Number : 303-333-3837
Fax Number : 303-333-8029
Provider Business Practice Location Address
First Line : 2810 QUEBEC ST
Second Line :
City : DENVER
State : CO
Zip : 80207-2900
Country : US
Telephone Number : 303-333-3837
Fax Number : 303-333-8029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2013
Last Update Date : 05/24/2013

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Directions to “ KIDANE TEKLEHAIMANOT RPH” Practice Location

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