Active NPI
Colonial Village
- Pharmacist
- Contoocook, NH
National Provider Identifier
1306822077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0101
- Legal business name
- COLONIAL VILLAGE
- Practice address
- 54 Park Ave Plaza
Contoocook, NH 03229-0338 - Phone
- (630) 746-4600
- Fax
- (603) 746-4117
- NPI assigned
- Dec 15, 2005
- Last updated
- May 5, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marc Real Fournier
- Title
- President Ceo
- Phone
- (603) 746-5085
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0101 | NH | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
54 Park Ave Plaza
Contoocook, NH 03229-0338
Mailing address
PO Box 338
Contoocook, NH 03229-0338
Phone (603) 746-5085
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3002552 | Other | NH | NABP |
| 80872938 | Medicaid | NH |
National Provider Directory
National Provider Directory- Tax ID family
- Colonial Pharmacy of Contoocook Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Colonial Village
- Durable Medical Equipment & Medical Supplies
- Contoocook, NH
- NPI 1245328475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209945600000",
"number": "1306822077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 338",
"city": "CONTOOCOOK",
"state": "NH",
"postal_code": "032290338",
"telephone_number": "603-746-5085",
"fax_number": "603-746-4117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 PARK AVE PLAZA",
"city": "CONTOOCOOK",
"state": "NH",
"postal_code": "032290338",
"telephone_number": "630-746-4600",
"fax_number": "603-746-4117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLONIAL VILLAGE",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-15",
"last_updated": "2008-05-05",
"status": "A",
"authorized_official_last_name": "FOURNIER",
"authorized_official_first_name": "MARC",
"authorized_official_middle_name": "REAL",
"authorized_official_title_or_position": "PRESIDENT CEO",
"authorized_official_telephone_number": "603-746-5085"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "0101",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "3002552",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80872938",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Contoocook, NH
- Aurora Chiropractic Health Center, Inc. (Aurora Counseling Services)
- Emily S Baker, MS, LCMHC
- Patricia A Cash, LCMHC
- Lindsay E Chase, ATC
- Colonial Pharmacy of Contoocook, Inc. (Colonial Village)
- Amy Dolores Deutsch, D.C.
- Jennifer Fitzgerald, LICSW
- Heidi Foisy, LCMHC
- Elizabeth D Foster, LICSW
- Jane Sullivan-Durand MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.