Provider Demographics
NPI:1376732842
Name:LOPEZ, TAMMY J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:J
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5563 MOUNTAIN GARLAND DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-8817
Mailing Address - Country:US
Mailing Address - Phone:719-260-4897
Mailing Address - Fax:719-520-7596
Practice Address - Street 1:27 E VERMIJO AVE
Practice Address - Street 2:SUITE 005
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2208
Practice Address - Country:US
Practice Address - Phone:719-520-7593
Practice Address - Fax:719-520-7596
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist