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General NPI Number Information
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NPI Number | 1043380470
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Entity Type | Organization
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Legal Business Name | FIRST COLONY CORP
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 82 NEWPORT RD
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City | NEW LONDON
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State | NH
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Zip | 03257-5414
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Country | US
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Telephone | 603-526-2233
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Fax | 603-526-2235
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | NEW LONDON
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State | NH
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Zip | 03257-0010
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Country | US
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Telephone | 603-526-2233
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Fax | 603-526-2235
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Authorized Official
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Title or Position | VP
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Name | GLENN PERREAULT
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Credential |
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Telephone | 603-526-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0313
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License Number State | NH
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