Basic Information
| Provider Information | |||||||||
| NPI: | 1548637838 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUKER | ||||||||
| FirstName: | MARCO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 ASPEN ST | ||||||||
| Address2: | |||||||||
| City: | NORWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703274233 | ||||||||
| FaxNumber: | 9703270656 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 ASPEN ST | ||||||||
| Address2: | |||||||||
| City: | NORWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703270655 | ||||||||
| FaxNumber: | 9703270656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2015 | ||||||||
| LastUpdateDate: | 09/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 09/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0020874 | CO | N | Pharmacy Service Providers | Pharmacist | 1835P0018X | 0020874 | CO | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.