Provider Demographics
NPI:1992043434
Name:CIORCIARI, ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:CIORCIARI
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 1:2512 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-2758
Mailing Address - Country:US
Mailing Address - Phone:970-257-0233
Mailing Address - Fax:
Practice Address - Street 1:2512 BROADWAY
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-2758
Practice Address - Country:US
Practice Address - Phone:970-257-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist