Provider Demographics
NPI:1770805525
Name:SADLER, MICHAEL GLENN (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GLENN
Last Name:SADLER
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 1:1400 E 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4306
Mailing Address - Country:US
Mailing Address - Phone:303-252-9150
Mailing Address - Fax:303-450-2573
Practice Address - Street 1:1400 E 104TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4306
Practice Address - Country:US
Practice Address - Phone:303-252-9150
Practice Address - Fax:303-450-2573
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist