Provider Demographics
NPI:1346239936
Name:ADKINS, RAYNETTE JUNE I
Entity Type:Individual
Prefix:
First Name:RAYNETTE
Middle Name:JUNE
Last Name:ADKINS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 MELODY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80260-5543
Mailing Address - Country:US
Mailing Address - Phone:303-450-0648
Mailing Address - Fax:
Practice Address - Street 1:700 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4532
Practice Address - Country:US
Practice Address - Phone:303-436-7776
Practice Address - Fax:303-436-8148
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13590OtherPHARMACIST