Provider Demographics
NPI:1831917202
Name:SADERUP, AUSTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:SADERUP
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 1:985 ALBION ST APT 343
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4979
Mailing Address - Country:US
Mailing Address - Phone:909-838-0256
Mailing Address - Fax:
Practice Address - Street 1:985 ALBION ST APT 343
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4979
Practice Address - Country:US
Practice Address - Phone:909-838-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00247931835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care