Provider Demographics
NPI:1326178484
Name:MCFADDEN, STEVEN R (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:R
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 MOUNTAIN VIEW AVE
Mailing Address - Street 2:PHARMACY DEPT
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3129
Mailing Address - Country:US
Mailing Address - Phone:303-651-5116
Mailing Address - Fax:303-651-5260
Practice Address - Street 1:1950 MOUNTAIN VIEW AVE
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3129
Practice Address - Country:US
Practice Address - Phone:303-651-5116
Practice Address - Fax:303-651-5260
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist