Provider Demographics
NPI:1336663962
Name:SCHOLL, TYLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:SCHOLL
Suffix:
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 1:7971 UPTOWN AVE UNIT 202
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4152
Mailing Address - Country:US
Mailing Address - Phone:303-946-4430
Mailing Address - Fax:303-946-4430
Practice Address - Street 1:1725 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:CO
Practice Address - Zip Code:80214-1303
Practice Address - Country:US
Practice Address - Phone:303-237-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist