Coles Care Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY352970 Issued in CA

Legal business name

COLES CARE PHARMACY

Doing business as

Coles Care Pharmacy

Practice address

16854 Ivy Ave
Suite C
Fontana, CA 92335-1504

Phone

(909) 356-0110

Fax

(909) 356-1024

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Misty Laree Cole, RPH

Title

Owner/Pharmacist

Phone

(909) 356-0110

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• COLES CARE PHARMACY Doing business as

Locations

Practitioners 1

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

• Jerry Daniel Cole, RPH

  • Pharmacist
  • Fontana, CA
  • NPI 1437178365
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1639348964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE",
            "address_2": "SUITE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-356-0110",
            "fax_number": "909-356-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE",
            "address_2": "SUITE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-356-0110",
            "fax_number": "909-356-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLES CARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "LAREE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "909-356-0110",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY352970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "0596354",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA352970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLES CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Coffin
• Czarina Colada, PHARM.D.
• Jerry Daniel Cole, RPH
• Robert Cole, MD
• Tiffany Ashley Coleman
• Lorraine M. Coli, MD
• Duane A. Collins, MD
• Comfort Path Medical LLC
• Aisha Sherman Commeh, D.P.M.
• Compean and Jefferson Dental Corporation (Triangle Dental Group And Orthodontics)

• Community/Retail Pharmacy in Fontana, CA
• Providers in Fontana, 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 Aug 8, 2013; 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.