Healthcare Provider Details

I. General information

NPI: 1053428193
Provider Name (Legal Business Name): COLONIAL PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 N CLEVELAND-MASSILLON RD
BATH OH
44210-0396
US

IV. Provider business mailing address

PO BOX 396
BATH OH
44210-0396
US

V. Phone/Fax

Practice location:
  • Phone: 330-666-3569
  • Fax:
Mailing address:
  • Phone: 330-666-3569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN MORGAN
Title or Position: OWNER/PIC
Credential:
Phone: 330-666-3569