Provider Demographics
NPI:1497389175
Name:GROB, ANN MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:GROB
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 1:8690 DECATUR ST APT 209
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6632
Mailing Address - Country:US
Mailing Address - Phone:303-748-7408
Mailing Address - Fax:
Practice Address - Street 1:8690 DECATUR ST APT 209
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6632
Practice Address - Country:US
Practice Address - Phone:303-748-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0022657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist