Provider Demographics
NPI:1023385788
Name:SAMAR, SHIRIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHIRIN
Middle Name:
Last Name:SAMAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2974 FOX SEDGE LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7588
Mailing Address - Country:US
Mailing Address - Phone:720-328-8666
Mailing Address - Fax:
Practice Address - Street 1:123 E BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-6802
Practice Address - Country:US
Practice Address - Phone:303-795-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist