Healthcare Provider Details
I. General information
NPI: 1518262898
Provider Name (Legal Business Name): COLFAX DRUG COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2011
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 DEPOT ST. #5
COLFAX CA
95713
US
IV. Provider business mailing address
6089 BIG BEND DR.
ROSEVILLE CA
95678
US
V. Phone/Fax
- Phone: 916-298-5498
- Fax:
- Phone: 916-298-5498
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
AENEAS
CHANCE
Title or Position: PHARMACIST/OWNER
Credential: PHARM.D./OWNER
Phone: 916-298-5498