Active NPI
KNB Pharmacy Inc
Doing business as Cooley Health Pharmacy
- Community/Retail Pharmacy
- Colton, CA
National Provider Identifier
1427356294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY50638
- Legal business name
- KNB PHARMACY INC
- Doing business as
- Cooley Health Pharmacy
- Practice address
- 1091 S Mount Vernon Ave Ste J
Colton, CA 92324-4219 - Phone
- (909) 514-1730
- Fax
- (909) 514-1316
- NPI assigned
- Mar 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Binh Nguyen
- Title
- Owner/Pic
- Phone
- (909) 514-1730
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY50638 | CA | Primary |
Addresses
Primary practice location
1091 S Mount Vernon Ave Ste J
Colton, CA 92324-4219
Mailing address
1091 S Mount Vernon Ave Ste J
Colton, CA 92324-4219
Phone (909) 514-1730
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427356294 | Medicaid | CA | |
| 2129589 | Other | PK |
Other names 1
- COOLEY HEALTH PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230830001871 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0648424044 | Practice locations: Colton, CA |
National Provider Directory
National Provider DirectoryLocations
1091 S Mount Vernon Ave
Ste J
Colton, CA 92324
Phone (909) 514-1730
1280 E Cooley Dr
Ste 23
Colton, CA 92324
Phone (909) 514-1730
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Colton, CA
- NPI 1720731011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747612800000",
"number": "1427356294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1091 S MOUNT VERNON AVE STE J",
"city": "COLTON",
"state": "CA",
"postal_code": "923244219",
"telephone_number": "909-514-1730",
"fax_number": "909-514-1316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1091 S MOUNT VERNON AVE STE J",
"city": "COLTON",
"state": "CA",
"postal_code": "923244219",
"telephone_number": "909-514-1730",
"fax_number": "909-514-1316"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KNB PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-03",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "BINH",
"authorized_official_title_or_position": "OWNER/PIC",
"authorized_official_telephone_number": "909-514-1730"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY50638",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1427356294",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2129589",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "COOLEY HEALTH PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.