Provider Demographics
NPI:1447568266
Name:BUCHANAN, BROOK (RPH)
Entity Type:Individual
Prefix:
First Name:BROOK
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5195 WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-4617
Mailing Address - Country:US
Mailing Address - Phone:303-463-3602
Mailing Address - Fax:303-463-3621
Practice Address - Street 1:5195 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-4617
Practice Address - Country:US
Practice Address - Phone:303-463-3602
Practice Address - Fax:303-463-3621
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist