Bridget Lee Colombo
Individual provider Active NPI Pharmacist · Raymore, MO
NPI 1215537469 · NPPES record last updated Oct 27, 2020
Key facts
- NPI
- 1215537469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2012024150 (MO)
- Practice address
- 141 N Dean Ave
Raymore, MO 64083-8398 - Phone
- (816) 425-9373
- NPI assigned
- Oct 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012024150 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sams East Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2012024150 | MO | Yes |
Addresses
Primary practice location
141 N Dean Ave
Raymore, MO 64083-8398
Mailing address
18900 S Prospect Ave
Belton, MO 64012-9633
Phone (785) 220-1439
Other providers in Raymore, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.