Healthcare Provider Details

I. General information

NPI: 1730794272
Provider Name (Legal Business Name): JENNIFER COLON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 STRAWBRIDGE DR
MOORESTOWN NJ
08057-4600
US

IV. Provider business mailing address

2004 SAGEMORE DR
MARLTON NJ
08053-4311
US

V. Phone/Fax

Practice location:
  • Phone: 866-648-2767
  • Fax:
Mailing address:
  • Phone: 310-210-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02717800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: