Provider Demographics
NPI:1306405238
Name:LOFTIS, COLIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:
Last Name:LOFTIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13310 N PLAZA DEL RIO BLVD UNIT 1055
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-0009
Mailing Address - Country:US
Mailing Address - Phone:716-307-7514
Mailing Address - Fax:
Practice Address - Street 1:5101 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2602
Practice Address - Country:US
Practice Address - Phone:623-247-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program