Provider Demographics
NPI:1609317940
Name:PHILLIPS, KIMBERLY (PHARM D)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:
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 1:6900 S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1418
Mailing Address - Country:US
Mailing Address - Phone:303-781-7187
Mailing Address - Fax:
Practice Address - Street 1:201 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3726
Practice Address - Country:US
Practice Address - Phone:303-781-7187
Practice Address - Fax:303-781-9854
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist