Provider Demographics
NPI:1093476145
Name:STOTZ, RUDOLPH CARL II (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:CARL
Last Name:STOTZ
Suffix:II
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 1:5675 PECOS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-6655
Mailing Address - Country:US
Mailing Address - Phone:720-596-9500
Mailing Address - Fax:
Practice Address - Street 1:5675 PECOS ST STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-6655
Practice Address - Country:US
Practice Address - Phone:720-596-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO123Medicaid