Healthcare Provider Details

I. General information

NPI: 1689198079
Provider Name (Legal Business Name): DAVID ANTHONY PASTORE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4503 JOHN F KENNEDY PKWY
FORT COLLINS CO
80525-3250
US

IV. Provider business mailing address

4503 JOHN F KENNEDY PKWY
FORT COLLINS CO
80525-3250
US

V. Phone/Fax

Practice location:
  • Phone: 970-223-5769
  • Fax:
Mailing address:
  • Phone: 970-631-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0021821
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: