Colonial Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH50000011 Issued in ME

Legal business name

COLONIAL PHARMACY INC

Doing business as

Colonial Pharmacy

Practice address

40 Dock SQ
Kennebunkport, ME 04046-6011

Phone

(207) 967-4442

Fax

(207) 967-3378

NPI assigned

Mar 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Tito

Title

Pharmacy Manager

Phone

(207) 967-4442

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• COLONIAL PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1013041557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 646",
            "city": "KENNEBUNKPORT",
            "state": "ME",
            "postal_code": "040460646",
            "telephone_number": "207-967-4442",
            "fax_number": "207-967-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DOCK SQ",
            "city": "KENNEBUNKPORT",
            "state": "ME",
            "postal_code": "040466011",
            "telephone_number": "207-967-4442",
            "fax_number": "207-967-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "TITO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "207-967-4442"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ME",
            "license": "PH50000011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035682",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLONIAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alan Ray Alexander, M.D.
• Eric Tyler Beaudoin, PSYD
• Kerry Bennett, LCPC
• Vincent E Bolton, M.D.
• Geoffrey M. Bove, DC, PHD
• David Betses
• Jennifer Dowling
• Erika Grant, MS RD LD CNSC
• Waylon Holbrook, HEALTH COACH
• Kennebunkport Emergency Medical Ser Incorporated

• Community/Retail Pharmacy in Kennebunkport, ME
• Providers in Kennebunkport, ME by specialty
• Community/Retail Pharmacy in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.