Provider Demographics
NPI:1548874886
Name:SMITH, SHARON M (PHARMD, MSHSA)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD, MSHSA
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:M
Other - Last Name:SMITH GRAGES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, MSHSA
Mailing Address - Street 1:12639 ELM ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3027
Mailing Address - Country:US
Mailing Address - Phone:970-412-3451
Mailing Address - Fax:
Practice Address - Street 1:12639 ELM ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3027
Practice Address - Country:US
Practice Address - Phone:970-412-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0023260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist