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Organization

COLES CARE PHARMACY

Active
Other names
COLES CARE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MISTY LAREE COLE RPH (OWNER/PHARMACIST)
(909) 356-0110
Entity
Organization

Contact information

Practice address
16854 IVY AVE, SUITE C, FONTANA, CA 92335-1504
(909) 356-0110
(909) 356-1024
Mailing address
16854 IVY AVE, SUITE C, FONTANA, CA 92335-1504
(909) 356-0110
(909) 356-1024

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY352970
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0596354
NABP NUMBER
CA
05
PHA352970
CA
Enumeration date
02/20/2008
Last updated
08/08/2013
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