Provider Demographics
NPI:1962426635
Name:COLSTON, ROWENA BARNEY (RPH)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:BARNEY
Last Name:COLSTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:
Other - Last Name:BARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 HAYWARD-DUPONT ST.
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:FL
Mailing Address - Zip Code:32343
Mailing Address - Country:US
Mailing Address - Phone:850-575-5529
Mailing Address - Fax:
Practice Address - Street 1:137 COLLEGIATE WAY
Practice Address - Street 2:FSU/TSHC
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-2140
Practice Address - Country:US
Practice Address - Phone:850-644-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist