Provider Demographics
NPI:1164094884
Name:MEHNI, MASSOOD
Entity Type:Individual
Prefix:
First Name:MASSOOD
Middle Name:
Last Name:MEHNI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1304
Mailing Address - Country:US
Mailing Address - Phone:303-331-0917
Mailing Address - Fax:
Practice Address - Street 1:2000 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1304
Practice Address - Country:US
Practice Address - Phone:303-331-0917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0023961183500000X
COPHA.0023691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPHA.0023961OtherCOLORADO BOARD OF PHARMACY