Provider Demographics
NPI:1982071759
Name:IRIZARRY, WILLIAM ERNESTO JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ERNESTO
Last Name:IRIZARRY
Suffix:JR
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 1:12731 GLENCOE ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3311
Mailing Address - Country:US
Mailing Address - Phone:915-309-0403
Mailing Address - Fax:
Practice Address - Street 1:4850 E 62ND AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-3288
Practice Address - Country:US
Practice Address - Phone:303-288-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist