Provider Demographics
NPI:1538899919
Name:ADAMS, NATHAN LYLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:LYLE
Last Name:ADAMS
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 1:5215 W OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4829
Mailing Address - Country:US
Mailing Address - Phone:720-326-0483
Mailing Address - Fax:
Practice Address - Street 1:17222 S GOLDEN RD
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2606
Practice Address - Country:US
Practice Address - Phone:303-457-5823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist