Healthcare Provider Details

I. General information

NPI: 1427160977
Provider Name (Legal Business Name): COLER DRUG MCCONNELSVILLE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N KENNEBEC AVE
MCCONNELSVILLE OH
43756-1254
US

IV. Provider business mailing address

PO BOX 3506
ZANESVILLE OH
43702-3506
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-2552
  • Fax: 740-962-2730
Mailing address:
  • Phone: 740-452-7685
  • Fax: 740-452-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021736450
License Number StateOH

VIII. Authorized Official

Name: JOHN E COLER
Title or Position: OWNER/MANAGER
Credential:
Phone: 740-452-7685