Provider Demographics
NPI:1548981012
Name:HOLTZ, PAIGE VICTORIA (PHARMD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:VICTORIA
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 N SHERMAN ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4045
Mailing Address - Country:US
Mailing Address - Phone:209-914-5283
Mailing Address - Fax:
Practice Address - Street 1:560 N CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3436
Practice Address - Country:US
Practice Address - Phone:303-777-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist