Provider Demographics
NPI:1669240214
Name:COLOMBOS PHARMACY LLC
Entity type:Organization
Organization Name:COLOMBOS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:ANTONINO
Authorized Official - Last Name:COLOMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-418-9700
Mailing Address - Street 1:7551 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2638
Mailing Address - Country:US
Mailing Address - Phone:718-418-9700
Mailing Address - Fax:718-418-7900
Practice Address - Street 1:7551 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2638
Practice Address - Country:US
Practice Address - Phone:718-418-9700
Practice Address - Fax:718-418-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy