Basic Information
Provider Information
NPI: 1285608257
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SVENSK
FirstName: TONJA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LAMBERTUS
OtherFirstName: TONJA
OtherMiddleName:  
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: RPH
OtherLastNameType: 1
Mailing Information
Address1: 1055 CLERMONT ST # 119
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber: 3033934624
Practice Location
Address1: 1055 CLERMONT ST (119)
Address2:  
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber: 3033934624
Other Information
ProviderEnumerationDate: 02/15/2006
LastUpdateDate: 08/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P1200X13291COY Pharmacy Service ProvidersPharmacistPharmacotherapy

No ID Information.


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