Provider Demographics
NPI:1942863931
Name:ALWALA, SAMMY (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMMY
Middle Name:
Last Name:ALWALA
Suffix:
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 1:14000 E EXPOSITION AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2538
Mailing Address - Country:US
Mailing Address - Phone:303-368-1116
Mailing Address - Fax:
Practice Address - Street 1:14000 E EXPOSITION AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2538
Practice Address - Country:US
Practice Address - Phone:303-368-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist