Provider Demographics
NPI:1568785632
Name:SHEALY, CARIE E (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARIE
Middle Name:E
Last Name:SHEALY
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 1:2575 S SYRACUSE WAY
Mailing Address - Street 2:H-302
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3832
Mailing Address - Country:US
Mailing Address - Phone:303-842-9567
Mailing Address - Fax:
Practice Address - Street 1:363 S BROADWAY
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1522
Practice Address - Country:US
Practice Address - Phone:303-733-8668
Practice Address - Fax:303-282-7802
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist