Organization
COLPHARM INC
Active
Other names
COLONIAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BIRTH RPH (PRES)
(570) 458-5573
Entity
Organization
Contact information
Practice address
283-285 MAIN ST, BENTON, PA 17814-0251
(570) 925-5403
(570) 925-2622
Mailing address
PO BOX 447, MILLVILLE, PA 17846
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP415407L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007631190001
—
PA
01
—
3974450
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/24/2006
Last updated
08/22/2020
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