Provider Demographics
NPI:1811279516
Name:TAI, JOANNA K (PHARM D)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:K
Last Name:TAI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4486 ELIOT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1414
Mailing Address - Country:US
Mailing Address - Phone:303-954-0741
Mailing Address - Fax:
Practice Address - Street 1:120 BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3917
Practice Address - Country:US
Practice Address - Phone:330-722-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist