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NPI Code Detail

MEDICARE: DR. ROBERT WILLIS JR. PHARMD

MEDICARE: DR. ROBERT WILLIS JR. 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
1183500000XPharmacist17848CO

General Provider Information

NPI Number : 1689974636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT WILLIS JR. PHARMD
Provider Business Mailing Address
First Line : 6220 E 14TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2747
Country : US
Telephone Number : 303-242-3535
Fax Number : 303-242-3527
Provider Business Practice Location Address
First Line : 6220 E 14TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2747
Country : US
Telephone Number : 303-242-3535
Fax Number : 303-242-3527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2010
Last Update Date : 10/25/2010

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