Provider Demographics
NPI:1447910799
Name:PAYNE, AARON (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:PAYNE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8481 PARKLAND ST APT 6-315
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4180
Mailing Address - Country:US
Mailing Address - Phone:317-771-0381
Mailing Address - Fax:
Practice Address - Street 1:16375 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80023-8907
Practice Address - Country:US
Practice Address - Phone:303-474-3254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6331156OtherVACCINE