Organization
COLORADO PHARMACY AND SUPPLY INC
Active
Other names
Colorado Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASYA SIMONYAN (OWNER)
(323) 254-6736
Entity
Organization
Contact information
Practice address
1680 COLORADO BLVD, LOS ANGELES, CA 90041-1436
(323) 254-6736
(323) 254-8772
Mailing address
1680 COLORADO BLVD, LOS ANGELES, CA 90041-1436
(323) 254-6736
(323) 254-8772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033190376
—
CA
01
—
PHY60520
PHARMACY PERMIT
CA
Enumeration date
11/11/2005
Last updated
03/24/2025
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