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NPI Code Detail

MEDICARE: DR. MICHAEL CROOKSTON PHARMD

MEDICARE: DR. MICHAEL CROOKSTON 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
1183500000XPharmacistPHA.0019701CO

General Provider Information

NPI Number : 1932471703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CROOKSTON PHARMD
Provider Business Mailing Address
First Line : 2724 MICHENER DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-6237
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2190 W DRAKE RD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1488
Country : US
Telephone Number : 970-484-5841
Fax Number : 970-484-6913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2012
Last Update Date : 06/17/2020

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