Provider Demographics
NPI:1417721168
Name:ESKENAZI, SAMUEL (RPH)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:ESKENAZI
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 1:18659 W 84TH DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7224
Mailing Address - Country:US
Mailing Address - Phone:404-861-6666
Mailing Address - Fax:
Practice Address - Street 1:1375 E SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2344
Practice Address - Country:US
Practice Address - Phone:303-673-1818
Practice Address - Fax:303-673-1981
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist