Active NPI
Prince M Tieku, PHARMD
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1386271799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21503
- Practice address
- 6001 E Woodmen Rd
Colorado Springs, CO 80923-2601 - Phone
- (719) 571-2311
- Fax
- (719) 571-2337
- NPI assigned
- Mar 25, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21503 | CO | Primary |
Addresses
Primary practice location
6001 E Woodmen Rd
Colorado Springs, CO 80923-2601
Mailing address
6001 E Woodmen Rd
Colorado Springs, CO 80923-2601
Phone (719) 571-2311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21503 | CO | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1386271799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6001 E WOODMEN RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809232601",
"telephone_number": "719-571-2311",
"fax_number": "719-571-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 E WOODMEN RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809232601",
"telephone_number": "719-571-2311",
"fax_number": "719-571-2337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEKU",
"first_name": "PRINCE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-25",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "21503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.