Provider Demographics
NPI:1699772137
Name:BOARMAN, SUSAN M (PHARMD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:BOARMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1827 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3327
Mailing Address - Country:US
Mailing Address - Phone:303-489-9485
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6663
Practice Address - Fax:303-757-5245
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11751183500000X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No183500000XPharmacy Service ProvidersPharmacist