Provider Demographics
NPI:1750671376
Name:LEMLEY, JIM ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:ROBERT
Last Name:LEMLEY
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 1:1103 W PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5664
Mailing Address - Country:US
Mailing Address - Phone:970-221-3073
Mailing Address - Fax:970-221-5782
Practice Address - Street 1:1103 W PROSPECT RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5664
Practice Address - Country:US
Practice Address - Phone:970-221-3073
Practice Address - Fax:970-221-5782
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist