Colorado Pharmacy and Supply Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COLORADO PHARMACY AND SUPPLY INC

Practice address

1680 Colorado Blvd
Los Angeles, CA 90041-1436

Phone

(323) 254-6736

Fax

(323) 254-8772

NPI assigned

Nov 11, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Asya Simonyan

Title

Owner

Phone

(323) 254-6736

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Colorado Medical Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

C N M Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Colorado Pharmacy and Supply Inc

  • Long Term Care Pharmacy
  • Los Angeles, CA
  • NPI 1255221602
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Haesun Cho, R.PH

  • Pharmacist
  • Los Angeles, CA
  • NPI 1760851760
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1033190376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411436",
            "telephone_number": "323-254-6736",
            "fax_number": "323-254-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 COLORADO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411436",
            "telephone_number": "323-254-6736",
            "fax_number": "323-254-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PHARMACY AND SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "SIMONYAN",
        "authorized_official_first_name": "ASYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-254-6736"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033190376",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "PHY60520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Medical Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Colon
• Melissa Domonique Colon, LPT
• Vianey Colon
• Colonial Drug Inc
• Colonial Drug Inc
• Colorado Pharmacy and Supply Inc
• Colorado Pharmacy Inc
• Sarah Anne Colosimo, CRNA
• Lakia A Colquitt
• Forest Colstrom, LCSW

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.