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General NPI Number Information
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NPI Number | 1396236089
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Entity Type | Individual
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Provider Name | COREY JAMES COLOMBINO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 3411 SAINT ROSE PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-4570
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Country | US
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Telephone | 702-803-7054
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Fax | 702-803-7045
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Provider Business Mailing Address
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Address Line | 6884 STONETRACE ST
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City | LAS VEGAS
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State | NV
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Zip | 89148-5095
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Country | US
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Telephone | 858-722-7597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | IN04221
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19887
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License Number State | NV
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