Provider Demographics
NPI:1497187694
Name:HUPP-TORGUSEN, AMY GAYLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GAYLE
Last Name:HUPP-TORGUSEN
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 1:3828 ANIMAS WAY
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-6114
Mailing Address - Country:US
Mailing Address - Phone:402-210-4874
Mailing Address - Fax:
Practice Address - Street 1:1650 30TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1014
Practice Address - Country:US
Practice Address - Phone:303-444-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist