Provider Demographics
NPI:1306169040
Name:MAR, PAUL K (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:K
Last Name:MAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6653 W GOULD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-5112
Mailing Address - Country:US
Mailing Address - Phone:303-730-3438
Mailing Address - Fax:
Practice Address - Street 1:200 W BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6610
Practice Address - Country:US
Practice Address - Phone:303-794-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist