Basic Information
Provider Information
NPI: 1588900617
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY OF COLORADO HOSPITAL AUTHORITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UNIVERSITY OF COLORADO HOSPITAL PHARMACY
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7901 E LOWRY BLVD
Address2: F402, 3RD FLOOR
City: DENVER
State: CO
PostalCode: 80230
CountryCode: US
TelephoneNumber:  
FaxNumber: 7205531754
Practice Location
Address1: 12605 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208486960
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/18/2012
LastUpdateDate: 01/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STOLPMAN
AuthorizedOfficialFirstName: NANCY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF PHARMACY
AuthorizedOfficialTelephone: 7208486976
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
333600000X533COY SuppliersPharmacy 

No ID Information.


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