Organization
COLORADO PHARMACY INC
Active
Other names
Colorado Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM BELITSKY (PRESIDENT/OWNER)
(323) 739-0011
Entity
Organization
Contact information
Practice address
2455 COLORADO BLVD APT 6, LOS ANGELES, CA 90041-1182
(323) 739-0011
(323) 474-6012
Mailing address
2455 COLORADO BLVD, SPACE # 6, LOS ANGELES, CA 90041-1170
(323) 739-0011
(323) 474-6012
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY52413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151741
PK
—
Enumeration date
04/15/2015
Last updated
06/09/2016
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