Provider Demographics
NPI:1518252402
Name:RICH, KRISTIN JO (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JO
Last Name:RICH
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 1:7899 WADSWORTH BLVD
Mailing Address - Street 2:T-0048
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2107
Mailing Address - Country:US
Mailing Address - Phone:303-425-8722
Mailing Address - Fax:303-425-8722
Practice Address - Street 1:7899 WADSWORTH BLVD
Practice Address - Street 2:T-0048
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2107
Practice Address - Country:US
Practice Address - Phone:303-425-8722
Practice Address - Fax:303-425-8722
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist