Provider Demographics
NPI:1326563123
Name:PATTERSON, ALEC JOHN ALAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:JOHN ALAN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:A.J.
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5100 RONALD REAGAN BLVD APT I208
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-6490
Mailing Address - Country:US
Mailing Address - Phone:316-650-5116
Mailing Address - Fax:
Practice Address - Street 1:1275 EAGLE DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-8058
Practice Address - Country:US
Practice Address - Phone:970-663-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00218821835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist