Provider Demographics
NPI:1902690951
Name:DICKINSON, BENJAMIN I (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:I
Last Name:DICKINSON
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 SHELDON DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-3343
Mailing Address - Country:US
Mailing Address - Phone:215-787-0550
Mailing Address - Fax:
Practice Address - Street 1:3690 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2244
Practice Address - Country:US
Practice Address - Phone:970-612-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0013570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist