Provider Demographics
NPI:1912208026
Name:BERSHOF, JOEL S (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:S
Last Name:BERSHOF
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 1:13111 W ALAMEDA PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3108
Mailing Address - Country:US
Mailing Address - Phone:303-980-0283
Mailing Address - Fax:303-980-0923
Practice Address - Street 1:13111 W ALAMEDA PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-3108
Practice Address - Country:US
Practice Address - Phone:303-980-0283
Practice Address - Fax:303-980-0923
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist