Provider Demographics
NPI:1811316466
Name:ENGEN, WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ENGEN
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 1:3334 APOLLO CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6309
Mailing Address - Country:US
Mailing Address - Phone:808-345-6814
Mailing Address - Fax:
Practice Address - Street 1:3334 APOLLO CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6309
Practice Address - Country:US
Practice Address - Phone:808-345-6814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist