Provider Demographics
NPI:1649709643
Name:MCCHRISTIAN, CULLEN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:CULLEN
Middle Name:
Last Name:MCCHRISTIAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 N CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3436
Mailing Address - Country:US
Mailing Address - Phone:303-777-6888
Mailing Address - Fax:
Practice Address - Street 1:560 N CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3436
Practice Address - Country:US
Practice Address - Phone:303-777-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist