Provider Demographics
NPI:1366573016
Name:HACKL, CAROL ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:HACKL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 WARD WAY STE A
Mailing Address - Street 2:WARD ROAD PHARMACY
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1346
Mailing Address - Country:US
Mailing Address - Phone:303-420-7979
Mailing Address - Fax:303-420-7980
Practice Address - Street 1:5656 WARD WAY STE A
Practice Address - Street 2:WARD ROAD PHARMACY
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1346
Practice Address - Country:US
Practice Address - Phone:303-420-7979
Practice Address - Fax:303-420-7980
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist