Provider Demographics
NPI:1528487618
Name:COLSON, CYNTHIA ANN (RPH)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:COLSON
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 1:11391 DUNBARTON BLVD # 259D
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-3033
Mailing Address - Country:US
Mailing Address - Phone:803-259-0066
Mailing Address - Fax:803-259-0181
Practice Address - Street 1:11391 DUNBARTON BLVD
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-3033
Practice Address - Country:US
Practice Address - Phone:803-259-0066
Practice Address - Fax:803-259-0181
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist