Active NPI
Amanda L Colistro, PHARMD
- Pharmacist
- Sierra Vista, AZ
National Provider Identifier
1558966002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S024845
- Practice address
- 500 N Highway 90 Byp
Sierra Vista, AZ 85635-2204 - Phone
- (520) 458-9690
- NPI assigned
- Dec 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S024845 | AZ | Primary |
Addresses
Primary practice location
500 N Highway 90 Byp
Sierra Vista, AZ 85635-2204
Mailing address
4650 N Central Ave Unit 439
Phoenix, AZ 85012-1091
Phone (623) 227-7939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S024845 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1558966002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 N CENTRAL AVE UNIT 439",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121091",
"telephone_number": "623-227-7939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N HIGHWAY 90 BYP",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352204",
"telephone_number": "520-458-9690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLISTRO",
"first_name": "AMANDA",
"middle_name": "L",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S024845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
- Cochise Sleep Center LLC
- Cochise Surgical Care PLLC
- Cochise Surgical Care, PLLC
- Cogent Healthcare of Arizona PC
- Richard Fred Cohen, D.P.M.
- Tyler William Joe Collier, DO
- Community Dialysis Center LLC
- Community Medical Services Arizona-Private, LLC
- Community Medical Services Arizona-Private, LLC
- Community Partners Integrated Healthcare, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.