Provider Demographics
NPI:1629411657
Name:GOLDFOGEL, DENISE GAYLE (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:GAYLE
Last Name:GOLDFOGEL
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 1:3475 S UNIVERSITY BLVD
Mailing Address - Street 2:UNIT E
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3154
Mailing Address - Country:US
Mailing Address - Phone:303-806-2770
Mailing Address - Fax:303-806-2775
Practice Address - Street 1:3475 S UNIVERSITY BLVD
Practice Address - Street 2:UNIT E
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3154
Practice Address - Country:US
Practice Address - Phone:303-806-2770
Practice Address - Fax:303-806-2775
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist