Provider Demographics
NPI:1154166833
Name:DNA PHARMACY
Entity type:Organization
Organization Name:DNA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EKHLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALAF
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:720-401-6718
Mailing Address - Street 1:2741 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6601
Mailing Address - Country:US
Mailing Address - Phone:720-401-6718
Mailing Address - Fax:
Practice Address - Street 1:2741 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6601
Practice Address - Country:US
Practice Address - Phone:720-401-6718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy