Provider Demographics
NPI:1851007975
Name:STONE, COLLEEN
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 ENTERPRISE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1106
Mailing Address - Country:US
Mailing Address - Phone:866-779-1696
Mailing Address - Fax:
Practice Address - Street 1:2800 ENTERPRISE ST STE 5
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1106
Practice Address - Country:US
Practice Address - Phone:866-779-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56315183500000X
MD28099183500000X
IN26025497A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist