Provider Demographics
NPI:1588623946
Name:HOFFMANN, GERALD L D (RPH)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:L D
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 OUTLOOK BLVD
Mailing Address - Street 2:SUITE 253
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-1667
Mailing Address - Country:US
Mailing Address - Phone:719-553-1051
Mailing Address - Fax:719-553-1100
Practice Address - Street 1:4112 OUTLOOK BLVD
Practice Address - Street 2:SUITE 253
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1667
Practice Address - Country:US
Practice Address - Phone:719-553-1051
Practice Address - Fax:719-553-1100
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112510-4183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist