Provider Demographics
NPI:1972066140
Name:VANVUREN, BRETT (PHARMD)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:VANVUREN
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 1:1250 E MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2702
Mailing Address - Country:US
Mailing Address - Phone:970-493-3934
Mailing Address - Fax:
Practice Address - Street 1:1250 E MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2702
Practice Address - Country:US
Practice Address - Phone:970-493-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist