| Organization Name: | COLVIN'S PHARMACY & MEDICAL SUPPLY, INC |
| NPI Number: | 1023284163 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES EDWARD MAIER (PRESIDENT) |
| Mailing Address: | 1411 Ee Wallace Blvd N Ferriday |
| State: | LA US |
| Postal Code: | 713342244 |
| Phone Number: | 3187578711 |
| Fax Number: | 3187578716 |
| NPI Enumeration Date: | 05/07/2008 |
| NPI Last Update Date: | 12/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 1842-IR |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |