Provider Demographics
NPI:1700038205
Name:ANTINORO, JOSEPH BRION (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:BRION
Last Name:ANTINORO
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 1:7016 CHATFORD CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3466
Mailing Address - Country:US
Mailing Address - Phone:303-663-6656
Mailing Address - Fax:303-795-0087
Practice Address - Street 1:100 E MINERAL AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2610
Practice Address - Country:US
Practice Address - Phone:303-795-0043
Practice Address - Fax:303-795-0087
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15266183500000X
NY044460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist