Provider Demographics
NPI:1114364494
Name:COLASANTE, JOSEPH C (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:COLASANTE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 BRONCO CIR
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1907
Mailing Address - Country:US
Mailing Address - Phone:267-614-3947
Mailing Address - Fax:
Practice Address - Street 1:7401 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-1323
Practice Address - Country:US
Practice Address - Phone:215-224-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist