Provider Demographics
NPI:1144515784
Name:HALLGARTH, DANIEL T (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:HALLGARTH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 FILLY LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1435
Mailing Address - Country:US
Mailing Address - Phone:719-495-3323
Mailing Address - Fax:
Practice Address - Street 1:9670 PROMINENT PT
Practice Address - Street 2:T-2221
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-5000
Practice Address - Country:US
Practice Address - Phone:719-302-4267
Practice Address - Fax:719-302-4277
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist