Provider Demographics
NPI:1093299570
Name:STEIN, BRENT J I (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:J
Last Name:STEIN
Suffix:I
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 1:18172 TELLER COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:CO
Mailing Address - Zip Code:80816
Mailing Address - Country:US
Mailing Address - Phone:303-810-6408
Mailing Address - Fax:
Practice Address - Street 1:18172 TELLER COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:CO
Practice Address - Zip Code:80816
Practice Address - Country:US
Practice Address - Phone:303-810-6408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO182231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist