Provider Demographics
NPI:1083901482
Name:PALUMBO, ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 BLOOMINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922
Mailing Address - Country:US
Mailing Address - Phone:719-574-7493
Mailing Address - Fax:
Practice Address - Street 1:3810 BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-3203
Practice Address - Country:US
Practice Address - Phone:719-574-7493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist