Provider Demographics
NPI:1306699079
Name:PETERS, TOBI LEE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:TOBI
Middle Name:LEE
Last Name:PETERS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 BLACKHAWK DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-8418
Mailing Address - Country:US
Mailing Address - Phone:970-430-8337
Mailing Address - Fax:
Practice Address - Street 1:5033 BLACKHAWK DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-8418
Practice Address - Country:US
Practice Address - Phone:970-430-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO148171835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric