Provider Demographics
NPI:1891302592
Name:STUHR, DAVID CHARLES (PHARMACIST)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:STUHR
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 1:412 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA JARA
Mailing Address - State:CO
Mailing Address - Zip Code:81140-5034
Mailing Address - Country:US
Mailing Address - Phone:719-274-5109
Mailing Address - Fax:719-274-4214
Practice Address - Street 1:412 MAIN ST
Practice Address - Street 2:
Practice Address - City:LA JARA
Practice Address - State:CO
Practice Address - Zip Code:81140-5034
Practice Address - Country:US
Practice Address - Phone:719-274-5109
Practice Address - Fax:719-274-4214
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist