MEDICARE: ASHTON JOHN MATTINSON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0023684	CO
2	183500000X	Pharmacist	4322	WY

General Provider Information

NPI Number	:	1295400927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHTON JOHN MATTINSON PHARMD

Provider Business Mailing Address
First Line	:	4625 S MASON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3740
Country	:	US
Telephone Number	:	970-372-3481
Fax Number	:	970-372-3480

Provider Business Practice Location Address
First Line	:	4625 S MASON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3740
Country	:	US
Telephone Number	:	970-372-3481
Fax Number	:	970-372-3481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	05/25/2026

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