Iesha M Colla, PHARM. D.

Individual provider Active NPI Pharmacist · Thomasville, GA

NPI 1508418112 · NPPES record last updated Dec 23, 2022

Key facts

NPI
1508418112
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RPH031263 (GA)
Practice address
11343 US Highway 319 N
Thomasville, GA 31757-3419
Phone
(229) 226-5424
Fax
(229) 226-5048
NPI assigned
Jul 13, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH031263GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Current
since Dec 28, 2022
Accepting new patients
Walgreen Co Past
since Dec 28, 2022
Accepting new patients

Locations

11343 US Highway 319 N
Thomasville, GA 31757
Phone (229) 226-5424

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH031263 GA Yes

Addresses

Primary practice location

11343 US Highway 319 N
Thomasville, GA 31757-3419

Mailing address

PO Box 971
Opelousas, LA 70571-0971
Phone (337) 692-1840

Other practice location 1

280 Compress Rd
Opelousas, LA 70570-1136
Phone (337) 942-2165

Other providers in Thomasville, GA

All providers in Thomasville, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.