Provider Demographics
NPI:1528727237
Name:VASILOPOULOS, CORRIE (PHARMD)
Entity type:Individual
Prefix:
First Name:CORRIE
Middle Name:
Last Name:VASILOPOULOS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CORRIE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4521 REED ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3521
Mailing Address - Country:US
Mailing Address - Phone:720-317-5939
Mailing Address - Fax:
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1281
Practice Address - Country:US
Practice Address - Phone:720-754-6348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00197471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy