Healthcare Provider Details

I. General information

NPI: 1619310539
Provider Name (Legal Business Name): JOHN BIESENDORFER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 S COLLEGE AVE
FORT COLLINS CO
80525-1725
US

IV. Provider business mailing address

2535 S COLLEGE AVE
FORT COLLINS CO
80525-1725
US

V. Phone/Fax

Practice location:
  • Phone: 970-212-0347
  • Fax:
Mailing address:
  • Phone: 970-212-0347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16789
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number16789
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: