Provider Demographics
NPI:1518409317
Name:COLON, ALLISON KATHLEEN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KATHLEEN
Last Name:COLON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:KATHLEEN
Other - Last Name:PAVKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:214 MARKS RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-6225
Mailing Address - Country:US
Mailing Address - Phone:330-472-4826
Mailing Address - Fax:
Practice Address - Street 1:6 E BAGLEY RD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-2009
Practice Address - Country:US
Practice Address - Phone:440-891-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03136193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist