Provider Demographics
NPI:1205452901
Name:SPANGLER, KEVIN ADAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ADAM
Last Name:SPANGLER
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 1:2871 KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2823
Mailing Address - Country:US
Mailing Address - Phone:208-661-8554
Mailing Address - Fax:
Practice Address - Street 1:499 E HAMPDEN AVE STE 150
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3875
Practice Address - Country:US
Practice Address - Phone:303-524-3750
Practice Address - Fax:303-524-3762
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist