Provider Demographics
NPI:1851862999
Name:PANSINI, CARL (RPH)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:PANSINI
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 1:16601 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:303-326-6766
Mailing Address - Fax:303-326-6762
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:303-326-6766
Practice Address - Fax:303-326-6762
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty