MEDICARE: COLORADO PHARMACY AND SUPPLY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1255221602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO PHARMACY AND SUPPLY INC

Provider Business Mailing Address
First Line	:	1680 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1436
Country	:	US
Telephone Number	:	323-254-6736
Fax Number	:	323-254-8772

Provider Business Practice Location Address
First Line	:	1680 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1436
Country	:	US
Telephone Number	:	323-254-6736
Fax Number	:	323-254-8772

Authorized Official
Title or Position	:	OWNER
Name	:	ASYA SIMONYAN
Credential	:
Telephone Number	:	323-254-6736

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	07/08/2025

Similar Medicare Providers

1033190376 — COLORADO PHARMACY AND SUPPLY INC
Practice Location Address:

1680 COLORADO BLVD
LOS ANGELES, CA
90041-1436

Practice Phone: 323-254-6736
Practice Fax: 323-254-8772

1760851760 — HAESUN CHO R.PH
Practice Location Address:

1680 COLORADO BLVD
LOS ANGELES, CA
90041-1436

Practice Phone: 323-254-6736
Practice Fax: 323-254-8772

1457289613 — HELP AT HOMECO LLC
Practice Location Address:

1436 S SHENANDOAH ST APT 103
LOS ANGELES, CA
90035-3544

Practice Phone: 331-235-6974
Practice Fax:

1003036807 — LORI MILLER
Practice Location Address:

600 E 7TH ST
LOS ANGELES, CA
90021-1436

Practice Phone: 213-537-0110
Practice Fax: 213-537-0880

1003077710 — 2ND CHANCE FOR RECOVERY, INC.
Practice Location Address:

600 E 7TH ST # 104-105
LOS ANGELES, CA
90021-1436

Practice Phone: 818-590-0111
Practice Fax: 866-754-1323

1780824557 — DR. KOUROSH MALEKI D.D.S.
Practice Location Address:

1436 ARMACOST AVE , SUITE #2
LOS ANGELES, CA
90025-2223

Practice Phone: 310-210-1251
Practice Fax:

Directions to “COLORADO PHARMACY AND SUPPLY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.