Healthcare Provider Details

I. General information

NPI: 1790876985
Provider Name (Legal Business Name): COLER DRUG NELSONVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATKINS ST
NELSONVILLE OH
45764
US

IV. Provider business mailing address

40 WATKINS ST.
NELSONVILLE OH
45764-1452
US

V. Phone/Fax

Practice location:
  • Phone: 740-753-2484
  • Fax: 740-753-4185
Mailing address:
  • Phone: 740-753-2484
  • Fax: 740-753-4185

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 TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02-1924250
License Number StateOH

VIII. Authorized Official

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