Organization Active NPI

KNB Pharmacy Inc

Doing business as Cooley Health Pharmacy

  • Community/Retail Pharmacy
  • Colton, CA
National Provider Identifier
1427356294
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50638 Issued in CA
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

Updated by the provider on May 19, 2025

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1427356294MedicaidCA
2129589OtherPK

Other names 1

  • COOLEY HEALTH PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230830001871 CA Part B Supplier - Mass Immunization (Roster Biller Only) 0648424044 Practice locations: Colton, CA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.