Provider Demographics
NPI:1982267175
Name:LANHAM, CHARLA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CHARLA
Middle Name:
Last Name:LANHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHARLA
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:13125 PARK MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4148
Mailing Address - Country:US
Mailing Address - Phone:479-739-4056
Mailing Address - Fax:
Practice Address - Street 1:78 N MCCULLOCH BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-4444
Practice Address - Country:US
Practice Address - Phone:719-647-9925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist