Organization
COLORADO PHARMACY AND SUPPLY INC
Active
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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