Provider Demographics
NPI:1881995959
Name:THILL, CLINTON W (RPH)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:W
Last Name:THILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6366 S BENTON WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-6810
Mailing Address - Country:US
Mailing Address - Phone:303-797-0354
Mailing Address - Fax:303-797-0354
Practice Address - Street 1:1575 W 84TH AVE
Practice Address - Street 2:
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260-4786
Practice Address - Country:US
Practice Address - Phone:303-427-9295
Practice Address - Fax:303-430-6603
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0012583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist