Provider Demographics
NPI:1891461091
Name:WARD, SAMANTHA JOSETTA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOSETTA
Last Name:WARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JOSETTA
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11849 S DONLEY ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8016
Mailing Address - Country:US
Mailing Address - Phone:303-883-9668
Mailing Address - Fax:
Practice Address - Street 1:15000 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6586
Practice Address - Country:US
Practice Address - Phone:303-883-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0020558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist