Provider Demographics
NPI:1578851705
Name:THOMPSON, ANGELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:LUETTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:12850 E MONTVIEW BLVD
Mailing Address - Street 2:V20-1127A
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2605
Mailing Address - Country:US
Mailing Address - Phone:303-724-2614
Mailing Address - Fax:
Practice Address - Street 1:12850 E MONTVIEW BLVD
Practice Address - Street 2:V20-1127A
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2605
Practice Address - Country:US
Practice Address - Phone:303-724-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist