Provider Demographics
NPI:1184067977
Name:ABRAHA, KAHSAY (RPH)
Entity type:Individual
Prefix:
First Name:KAHSAY
Middle Name:
Last Name:ABRAHA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 KRAMERIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2729
Mailing Address - Country:US
Mailing Address - Phone:303-388-1689
Mailing Address - Fax:303-388-0281
Practice Address - Street 1:1355 KRAMERIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2729
Practice Address - Country:US
Practice Address - Phone:303-388-1689
Practice Address - Fax:303-388-0281
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist