Provider Demographics
NPI:1942500921
Name:LEWIS, DEMAR III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEMAR
Middle Name:
Last Name:LEWIS
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 S COLUMBINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4729
Mailing Address - Country:US
Mailing Address - Phone:303-578-0499
Mailing Address - Fax:866-457-6729
Practice Address - Street 1:1024 S COLUMBINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4729
Practice Address - Country:US
Practice Address - Phone:303-578-0499
Practice Address - Fax:866-457-6729
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37541183500000X, 1835N1003X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist