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General NPI Number Information
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NPI Number | 1861624926
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Entity Type | Individual
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Provider Name | BENJAMIN J GUECK PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 1024 S LEMAY AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-3929
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Country | US
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Telephone | 970-817-0656
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 544
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City | WELLINGTON
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State | CO
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Zip | 80549-0544
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Country | US
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Telephone | 970-817-0656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0018683
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License Number State | CO
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