Provider Demographics
NPI:1669755815
Name:COLLAMORE, KATHRYN (PHARMD, RPH)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:COLLAMORE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2268 E HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3412
Mailing Address - Country:US
Mailing Address - Phone:970-530-2692
Mailing Address - Fax:970-612-0246
Practice Address - Street 1:2370 W EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3150
Practice Address - Country:US
Practice Address - Phone:970-612-0243
Practice Address - Fax:970-612-0246
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10854183500000X
WY3136183500000X
AZS010561183500000X
FLPS20807183500000X
CO17370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist