Provider Demographics
NPI:1447553367
Name:COLOMB, SANDRA SALTZMANN (R PH)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:SALTZMANN
Last Name:COLOMB
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 ROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4732
Mailing Address - Country:US
Mailing Address - Phone:434-984-3905
Mailing Address - Fax:434-984-5505
Practice Address - Street 1:1904 EMMET ST N
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2815
Practice Address - Country:US
Practice Address - Phone:434-295-2132
Practice Address - Fax:434-295-0677
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist