Provider Demographics
NPI:1467678383
Name:CHAVEZ, BENJAMIN (PHARMD, BCPP)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S ROLLIE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1508
Mailing Address - Country:US
Mailing Address - Phone:303-697-2583
Mailing Address - Fax:
Practice Address - Street 1:6255 QUEBEC PKWY
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-4812
Practice Address - Country:US
Practice Address - Phone:036-972-5833
Practice Address - Fax:303-286-4970
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00209881835P1300X, 1835P2201X
NJ28RI030551001835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric