Provider Demographics
NPI:1891417309
Name:KAYALI, LORA (RPH)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:KAYALI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 W BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-1007
Mailing Address - Country:US
Mailing Address - Phone:720-400-6602
Mailing Address - Fax:
Practice Address - Street 1:9229 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5502
Practice Address - Country:US
Practice Address - Phone:303-649-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0024205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist