Provider Demographics
NPI:1861000515
Name:GREENE, MEGAN (PHARMD, BCPPS)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHARMD, BCPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5556
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE # B100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00218581835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatricsGroup - Single Specialty