Basic Information
Provider Information
NPI: 1992773808
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLACH
FirstName: LYNN
MiddleName: ANNE
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 N BROADWAY FL 7
Address2:  
City: DENVER
State: CO
PostalCode: 802033407
CountryCode: US
TelephoneNumber: 3036024221
FaxNumber:  
Practice Location
Address1: 601 N BROADWAY FL 7
Address2:  
City: DENVER
State: CO
PostalCode: 802033407
CountryCode: US
TelephoneNumber: 3036024221
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/08/2006
LastUpdateDate: 11/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P0018X15848COY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

No ID Information.


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