Provider Demographics
NPI:1780036863
Name:BENABE, JOSELYN (CLINICAL PHARMACIST)
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:
Last Name:BENABE
Suffix:
Gender:F
Credentials:CLINICAL PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6005
Mailing Address - Country:US
Mailing Address - Phone:303-812-4790
Mailing Address - Fax:503-357-4371
Practice Address - Street 1:500 ELDORADO BLVD BLDG 4
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3408
Practice Address - Country:US
Practice Address - Phone:303-812-4790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00210221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1629515028OtherNPI