MEDICARE: DEBORAH LYNNE LICHTENBERG 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
1	183500000X	Pharmacist	10674	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10674	OTHER	CO	PHARMACIST LISC

General Provider Information

NPI Number	:	1992794358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNNE LICHTENBERG RPH.

Provider Business Mailing Address
First Line	:	130 PEARL ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-4192
Country	:	US
Telephone Number	:	303-328-5544
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 DELAWARE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4532
Country	:	US
Telephone Number	:	303-436-7776
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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