Provider Demographics
NPI:1235209057
Name:COLROB INC.
Entity Type:Organization
Organization Name:COLROB INC.
Other - Org Name:FARMACIA LA PROVIDENCIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF COLROB INC / FARMACIA
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-820-3421
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0007
Mailing Address - Country:US
Mailing Address - Phone:787-820-3421
Mailing Address - Fax:787-820-1925
Practice Address - Street 1:ROAD #113 INT. ROAD #119
Practice Address - Street 2:KM 13.9 (PIEDRA GORDA DISTRICT)
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-0007
Practice Address - Country:US
Practice Address - Phone:787-820-3421
Practice Address - Fax:787-820-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR12-F-2900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy