Provider Demographics
NPI:1982427738
Name:KORTUS, JAMES A (MBA PHARMD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:KORTUS
Suffix:
Gender:M
Credentials:MBA PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23761 E ALABAMA DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-3023
Mailing Address - Country:US
Mailing Address - Phone:402-213-6159
Mailing Address - Fax:
Practice Address - Street 1:2222 N NEVADA AVE STE 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6794
Practice Address - Country:US
Practice Address - Phone:719-776-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0024995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist