Provider Demographics
NPI:1578907648
Name:YOHANNES, LEMLEM
Entity Type:Individual
Prefix:
First Name:LEMLEM
Middle Name:
Last Name:YOHANNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18211 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3532
Mailing Address - Country:US
Mailing Address - Phone:303-627-3301
Mailing Address - Fax:303-627-3311
Practice Address - Street 1:18211 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3532
Practice Address - Country:US
Practice Address - Phone:303-627-3301
Practice Address - Fax:303-627-3311
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist