Derek J Reynolds, PHARMD
Individual provider Active NPI Pharmacist · Clifton, CO
NPI 1154893220 · NPPES record last updated Dec 29, 2018
Key facts
- NPI
- 1154893220
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 22222 (CO)
- Practice address
- 572 32 Rd
Clifton, CO 81520-7606 - Phone
- (970) 523-0193
- NPI assigned
- Dec 29, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22222 | CO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22222 | CO | Yes |
Addresses
Primary practice location
572 32 Rd
Clifton, CO 81520-7606
Mailing address
572 32 Rd
Clifton, CO 81520-7606
Phone (970) 523-0193
Other providers in Clifton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.