Provider Demographics
NPI:1548559503
Name:BOKA, ADRIAN LARKIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:LARKIN
Last Name:BOKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:TUCKER
Other - Last Name:LARKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:790 DELAWARE STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4995 E 33RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1902
Practice Address - Country:US
Practice Address - Phone:303-602-8113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040071183500000X
CO19081183500000X
CO00190811835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist