NPIMap

Organization Active NPI

Colonial Pharmacy Inc

Doing business as Colonial Pharmacy

  • Community/Retail Pharmacy
  • Arcadia, CA
National Provider Identifier
1578749941
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
44156 Issued in CA
Legal business name
COLONIAL PHARMACY INC
Doing business as
Colonial Pharmacy
Practice address
1326 S Baldwin Ave
Arcadia, CA 91007-7512
Phone
(626) 447-3591
Fax
(626) 447-4679
NPI assigned
Jan 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Mark BurstynNPI 1013095678
Title
President/Pic
Phone
(626) 447-3591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 44156 CA Primary

Addresses

Primary practice location

1326 S Baldwin Ave
Arcadia, CA 91007-7512

Mailing address

1326 S Baldwin Ave
Arcadia, CA 91007-7512
Phone (626) 447-3591

Other identifiers 2

IdentifierTypeStateIssuer
PHA441560MedicaidCA
5636456OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • COLONIAL PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1326 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 447-3591

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1578749941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 S BALDWIN AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077512",
            "telephone_number": "626-447-3591",
            "fax_number": "626-447-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 S BALDWIN AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077512",
            "telephone_number": "626-447-3591",
            "fax_number": "626-447-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "BURSTYN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "626-447-3591"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "44156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA441560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5636456",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLONIAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.