Provider Demographics
NPI:1366947111
Name:COLER DRUG ATHENS LTD
Entity type:Organization
Organization Name:COLER DRUG ATHENS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER,MGR,AO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-452-7685
Mailing Address - Street 1:PO BOX 3506
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-3506
Mailing Address - Country:US
Mailing Address - Phone:740-452-7685
Mailing Address - Fax:740-452-7665
Practice Address - Street 1:310 W UNION ST STE 101
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2312
Practice Address - Country:US
Practice Address - Phone:740-452-7685
Practice Address - Fax:740-452-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH022861750-033336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176081OtherPK