Provider Demographics
NPI:1184961609
Name:COLBY, KRISTINE (RPH)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:
Last Name:COLBY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1862
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329-1862
Mailing Address - Country:US
Mailing Address - Phone:912-964-1797
Mailing Address - Fax:
Practice Address - Street 1:7300 GA HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31407-9205
Practice Address - Country:US
Practice Address - Phone:912-964-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024072183500000X
NH2955183500000X
SC13872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist