Provider Demographics
NPI:1043595846
Name:HAUKOOS, CHAD ROYCE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:ROYCE
Last Name:HAUKOOS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12051 E MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2834
Mailing Address - Country:US
Mailing Address - Phone:303-340-8860
Mailing Address - Fax:303-340-8874
Practice Address - Street 1:12051 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2834
Practice Address - Country:US
Practice Address - Phone:303-340-8860
Practice Address - Fax:303-340-8874
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist