MEDICARE: COLT STRATEGIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	27280	TX

General Provider Information

NPI Number	:	1891090593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLT STRATEGIES LLC

Provider Business Mailing Address
First Line	:	5228 ALDINE MAIL RD
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77039-3804
Country	:	US
Telephone Number	:	281-741-3385
Fax Number	:	281-741-3915

Provider Business Practice Location Address
First Line	:	5228 ALDINE MAIL RD
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77039-3804
Country	:	US
Telephone Number	:	281-741-3385
Fax Number	:	281-741-3915

Authorized Official
Title or Position	:	PIC
Name	:	MRS. AMY B IMBER
Credential	:	RPH
Telephone Number	:	281-741-3385

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	06/12/2014

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