Organization
COLONIAL HEALTH PHARMACY
Active
Other names
COLONIAL HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LATCHMAN RAGHUNADAN BS (MANG)
(973) 824-5010
Entity
Organization
Contact information
Practice address
125 AVON AVE, NEWARK, NJ 07108-2531
(973) 824-5010
(973) 799-0066
Mailing address
125 AVON AVE, NEWARK, NJ 07108-2531
(973) 824-5010
(973) 799-0066
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00571100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054145
PK
—
05
—
7946007
—
NJ
Enumeration date
07/12/2006
Last updated
07/19/2018
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