Provider Demographics
NPI:1285077271
Name:GEBREMARIAM, YONAS W (PHARMD)
Entity type:Individual
Prefix:
First Name:YONAS
Middle Name:W
Last Name:GEBREMARIAM
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 1:3600 TABLE MESA DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5800
Mailing Address - Country:US
Mailing Address - Phone:303-499-4244
Mailing Address - Fax:303-497-2204
Practice Address - Street 1:3600 TABLE MESA DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5800
Practice Address - Country:US
Practice Address - Phone:303-499-4244
Practice Address - Fax:303-497-2204
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16726183500000X, 1835G0303X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy