Provider Demographics
NPI:1942580667
Name:DAMSCHRODER, CHARITY
Entity Type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:
Last Name:DAMSCHRODER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHARITY
Other - Middle Name:
Other - Last Name:MCNEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4669 E EUCLID CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4175 E WILDCAT RESERVE PKWY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-6800
Practice Address - Country:US
Practice Address - Phone:720-214-4910
Practice Address - Fax:720-214-5622
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15762183500000X
MA23677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist