Provider Demographics
NPI:1730462383
Name:BORCHERT, JODI LYNN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:BORCHERT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 STONEWAY CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5615
Mailing Address - Country:US
Mailing Address - Phone:970-612-0278
Mailing Address - Fax:970-612-0281
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:970-612-0281
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist