Organization
COLONIAL PHARMACY INC
Active
Other names
COLONIAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GARY TITO (PHARMACY MANAGER)
(207) 967-4442
Entity
Organization
Contact information
Practice address
40 DOCK SQ, KENNEBUNKPORT, ME 04046-6011
(207) 967-4442
(207) 967-3378
Mailing address
PO BOX 646, KENNEBUNKPORT, ME 04046-0646
(207) 967-4442
(207) 967-3378
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50000011
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035682
PK
—
Enumeration date
03/15/2007
Last updated
03/27/2017
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