Provider Demographics
NPI:1629342134
Name:FARAHANI, SHOKOOFEH (RPH)
Entity Type:Individual
Prefix:
First Name:SHOKOOFEH
Middle Name:
Last Name:FARAHANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 E CENTRETECH PKWY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9045
Mailing Address - Country:US
Mailing Address - Phone:303-739-4900
Mailing Address - Fax:303-739-4927
Practice Address - Street 1:16601 E CENTRETECH PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9045
Practice Address - Country:US
Practice Address - Phone:303-739-4900
Practice Address - Fax:303-739-4927
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18787183500000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No302R00000XManaged Care OrganizationsHealth Maintenance Organization