# COLONIAL HEALTH PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COLONIAL HEALTH PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437184926
- **Authorized official:** LATCHMAN RAGHUNADAN BS (MANG)
- **Authorized official phone:** (973) 824-5010

## Contact information

- **Practice address:** 125 AVON AVE, NEWARK, NJ 07108-2531
- **Practice address phone:** (973) 824-5010
- **Practice address fax:** (973) 799-0066
- **Mailing address:** 125 AVON AVE, NEWARK, NJ 07108-2531
- **Mailing address phone:** (973) 824-5010
- **Mailing address fax:** (973) 799-0066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00571100 | NJ | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 07/19/2018