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NPI Code Detail

MEDICARE: MARY LOUISE ROLDAN CRABTREE RPH

MEDICARE: MARY LOUISE ROLDAN CRABTREE 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
1183500000XPharmacist17740CO

General Provider Information

NPI Number : 1821375296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LOUISE ROLDAN CRABTREE RPH
Provider Business Mailing Address
First Line : 7545 JELLISON CT
Second Line :
City : ARVADA
State : CO
Zip : 80005-4052
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7211 FEDERAL BLVD
Second Line :
City : WESTMINSTER
State : CO
Zip : 80030-4901
Country : US
Telephone Number : 303-427-7479
Fax Number : 303-427-7549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2011
Last Update Date : 11/13/2011

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