Provider Demographics
NPI:1568706935
Name:POLCHAK, RHONDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:POLCHAK
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 1:816 ACOMA ST
Mailing Address - Street 2:UNIT 609
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4010
Mailing Address - Country:US
Mailing Address - Phone:720-427-0632
Mailing Address - Fax:
Practice Address - Street 1:7930 NORTHFIELD BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3527
Practice Address - Country:US
Practice Address - Phone:720-333-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-24
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist