Individual provider Active NPI

Stefan Daniel Calabrese, RPH

  • Pharmacist
  • Glendale, CO
National Provider Identifier
1558964064
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0022318 Issued in CO
Practice address
4301 E Virginia Ave
Glendale, CO 80246-1510
Phone
(303) 209-0183
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0022318 CO Primary

Addresses

Primary practice location

4301 E Virginia Ave
Glendale, CO 80246-1510

Mailing address

4301 E Virginia Ave
Glendale, CO 80246-1510
Phone (303) 209-0183

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0022318COMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1558964064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 E VIRGINIA AVE",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461510",
            "telephone_number": "303-209-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 E VIRGINIA AVE",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461510",
            "telephone_number": "303-209-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "STEFAN",
        "middle_name": "DANIEL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0022318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.