Colorado Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY52413 Issued in CA

Legal business name

COLORADO PHARMACY INC

Doing business as

Colorado Pharmacy

Practice address

2455 Colorado Blvd Apt 6
Los Angeles, CA 90041-1182

Phone

(323) 739-0011

Fax

(323) 474-6012

NPI assigned

Apr 15, 2015

Last updated

Jun 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vadim Belitsky

Title

President/Owner

Phone

(323) 739-0011

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Colorado Pharmacy Doing business as

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1447646518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 COLORADO BLVD",
            "address_2": "SPACE # 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411170",
            "telephone_number": "323-739-0011",
            "fax_number": "323-474-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 COLORADO BLVD APT 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411182",
            "telephone_number": "323-739-0011",
            "fax_number": "323-474-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "BELITSKY",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "323-739-0011"
    },
    "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": "PHY52413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151741",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.