NPIMap

Organization Active NPI

Colpharm Inc

  • Community/Retail Pharmacy
  • Benton, PA
National Provider Identifier
1124040795
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP415407L Issued in PA
Legal business name
COLPHARM INC
Practice address
283-285 Main St
Benton, PA 17814-0251
Phone
(570) 925-5403
Fax
(570) 925-2622
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Birth, RPH
Title
Pres
Phone
(570) 458-5573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP415407L PA Primary

Addresses

Primary practice location

283-285 Main St
Benton, PA 17814-0251

Mailing address

PO Box 447
Millville, PA 17846

Other identifiers 2

IdentifierTypeStateIssuer
1007631190001MedicaidPA
3974450OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • COLONIAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colonial Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124040795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "MILLVILLE",
            "state": "PA",
            "postal_code": "17846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283-285 MAIN ST",
            "city": "BENTON",
            "state": "PA",
            "postal_code": "178140251",
            "telephone_number": "570-925-5403",
            "fax_number": "570-925-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLPHARM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIRTH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "570-458-5573",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP415407L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007631190001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3974450",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLONIAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.