Provider Demographics
NPI:1669772646
Name:WOLDEYES, HABTAMU ASSEFA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HABTAMU
Middle Name:ASSEFA
Last Name:WOLDEYES
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 1:14708 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3770
Mailing Address - Country:US
Mailing Address - Phone:303-751-2194
Mailing Address - Fax:
Practice Address - Street 1:14708 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3770
Practice Address - Country:US
Practice Address - Phone:303-751-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist