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NPI Code Detail

MEDICARE: SUSAN M BOARMAN PHARM.D.

MEDICARE: SUSAN M BOARMAN PHARM.D.
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
1183500000XPharmacist11751CO
21835P1300XPsychiatric Pharmacist11751CO

General Provider Information

NPI Number : 1699772137
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M BOARMAN PHARM.D.
Provider Business Mailing Address
First Line : 1827 S FRANKLIN ST
Second Line :
City : DENVER
State : CO
Zip : 80210-3327
Country : US
Telephone Number : 303-489-9485
Fax Number :
Provider Business Practice Location Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6663
Fax Number : 303-757-5245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 03/13/2021

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