Provider Demographics
NPI:1235826009
Name:BLUM, ALEXANDER F (PHARMACY INTERN)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:F
Last Name:BLUM
Suffix:
Gender:M
Credentials:PHARMACY INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9123 E MISSISSIPPI AVE
Mailing Address - Street 2:E1 BLDG 13 UNIT 302
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 E VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1510
Practice Address - Country:US
Practice Address - Phone:303-209-0183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COIN.0002008756390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program