Provider Demographics
NPI:1659721983
Name:ANDERSON, MONICA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:IL
Mailing Address - Zip Code:61360-9692
Mailing Address - Country:US
Mailing Address - Phone:815-258-8598
Mailing Address - Fax:
Practice Address - Street 1:1855 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2452
Practice Address - Country:US
Practice Address - Phone:719-473-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021183183500000X
COPHA0021183261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology