Provider Demographics
NPI:1083426407
Name:QUACH, STEPHANIE (RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:QUACH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 E 102ND PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2752
Mailing Address - Country:US
Mailing Address - Phone:720-238-7269
Mailing Address - Fax:
Practice Address - Street 1:2880 W HOLDEN PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3353
Practice Address - Country:US
Practice Address - Phone:303-953-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0024988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist