Provider Demographics
NPI:1093591729
Name:MCCANN, THALIA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THALIA
Middle Name:MARIE
Last Name:MCCANN
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 1:1762 S TRENTON ST APT 10
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA855091835I0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835I0206XPharmacy Service ProvidersPharmacistInfectious Diseases