Provider Demographics
NPI:1306431069
Name:BEITSCHER, ROBERT JOEL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOEL
Last Name:BEITSCHER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8858 NIGHTINGALE WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5264
Mailing Address - Country:US
Mailing Address - Phone:970-485-9901
Mailing Address - Fax:
Practice Address - Street 1:8858 NIGHTINGALE WAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80126-5264
Practice Address - Country:US
Practice Address - Phone:970-485-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty