Provider Demographics
NPI:1699396481
Name:CASTER, HENRY ANTHONY JR (PHARMD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:ANTHONY
Last Name:CASTER
Suffix:JR
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 1:2105 BUCHTEL BLVD APT 310
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3477
Mailing Address - Country:US
Mailing Address - Phone:513-205-1109
Mailing Address - Fax:
Practice Address - Street 1:1615 PLATTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1581
Practice Address - Country:US
Practice Address - Phone:513-205-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-03
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist