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General NPI Number Information
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NPI Number | 1255221602
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Entity Type | Organization
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Legal Business Name | COLORADO PHARMACY AND SUPPLY INC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 1680 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-1436
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Country | US
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Telephone | 323-254-6736
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Fax | 323-254-8772
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Provider Business Mailing Address
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Address Line | 1680 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-1436
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Country | US
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Telephone | 323-254-6736
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Fax | 323-254-8772
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Authorized Official
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Title or Position | OWNER
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Name | ASYA SIMONYAN
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Credential |
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Telephone | 323-254-6736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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