Provider Demographics
NPI:1134795198
Name:CLOYD, COLLEEN PATRICIA (PHARMD, BCPPS)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:PATRICIA
Last Name:CLOYD
Suffix:
Gender:F
Credentials:PHARMD, BCPPS
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:PATRICIA
Other - Last Name:MCGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2796 BRACKLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4246
Mailing Address - Country:US
Mailing Address - Phone:614-722-2322
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2639
Practice Address - Country:US
Practice Address - Phone:614-722-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032374771835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics