Provider Demographics
NPI:1003932617
Name:KORNER, ELI J (PHARMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ELI
Middle Name:J
Last Name:KORNER
Suffix:
Gender:M
Credentials:PHARMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 HUMBOLDT ST
Mailing Address - Street 2:#PH-E
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2470
Mailing Address - Country:US
Mailing Address - Phone:303-929-6460
Mailing Address - Fax:
Practice Address - Street 1:1260 HUMBOLDT ST
Practice Address - Street 2:#PH-E
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2470
Practice Address - Country:US
Practice Address - Phone:303-929-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO164951835P1200X
IL512873461835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
014352OtherKAISER-COMMERCIAL NUMBER