Organization
COLONIAL VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC REAL FOURNIER (PRESIDENT CEO)
(603) 746-5085
Entity
Organization
Contact information
Practice address
54 PARK AVE PLAZA, CONTOOCOOK, NH 03229-0338
(630) 746-4600
(603) 746-4117
Mailing address
PO BOX 338, CONTOOCOOK, NH 03229-0338
(603) 746-5085
(603) 746-4117
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0101
NH
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3002552
NABP
NH
05
—
80872938
—
NH
Enumeration date
12/15/2005
Last updated
05/05/2008
About Stedi
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