Provider Demographics
NPI:1952601494
Name:CHASE, LEWIS BARNETT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:BARNETT
Last Name:CHASE
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 1:33002 J RD
Mailing Address - Street 2:
Mailing Address - City:HOTCHKISS
Mailing Address - State:CO
Mailing Address - Zip Code:81419-9640
Mailing Address - Country:US
Mailing Address - Phone:970-399-7131
Mailing Address - Fax:
Practice Address - Street 1:1550 HWY 92
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3405
Practice Address - Country:US
Practice Address - Phone:970-874-9091
Practice Address - Fax:970-874-9092
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist