Provider Demographics
NPI:1194068387
Name:LENNICK, SCOTT (PHARMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:LENNICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11747 W KEN CARYL AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3700
Mailing Address - Country:US
Mailing Address - Phone:303-933-5119
Mailing Address - Fax:303-933-5126
Practice Address - Street 1:11747 W KEN CARYL AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3700
Practice Address - Country:US
Practice Address - Phone:303-933-5119
Practice Address - Fax:303-933-5126
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist