Individual
MRS. MARY ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
200 W BELLEVIEW AVE, ENGLEWOOD, CO 80110-6610
(303) 794-0801
Mailing address
5981 S EUDORA WAY, CENTENNIAL, CO 80121-3329
(303) 771-3902
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13102
CO
183500000X
Pharmacist
RP00004357
NM
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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