Basic Information
| Provider Information | |||||||||
| NPI: | 1174570980 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMBROZY | ||||||||
| FirstName: | COLLEEN | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | BS PHARM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11740 SPRUCE CANYON CIR | ||||||||
| Address2: | |||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804038441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036427537 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1055 CLERMONT ST | ||||||||
| Address2: | DENVER VA MEDICAL CENTER # 119 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033998020 | ||||||||
| FaxNumber: | 3033935161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 13433 | CO | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.