Provider Demographics
NPI:1316075195
Name:TERONDE, JOHN MARK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:TERONDE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 LOWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3147
Mailing Address - Country:US
Mailing Address - Phone:303-455-2194
Mailing Address - Fax:
Practice Address - Street 1:3428 LOWELL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3147
Practice Address - Country:US
Practice Address - Phone:303-455-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16115183500000X
WY2499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist