Provider Demographics
NPI:1083180657
Name:COLTONS RX INC
Entity Type:Organization
Organization Name:COLTONS RX INC
Other - Org Name:COLTONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NALABOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-353-8200
Mailing Address - Street 1:851 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2755
Mailing Address - Country:US
Mailing Address - Phone:908-353-8200
Mailing Address - Fax:908-353-7340
Practice Address - Street 1:851 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2755
Practice Address - Country:US
Practice Address - Phone:908-353-8200
Practice Address - Fax:908-353-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0714470Medicaid