| NPI | 1043314099 |
|---|---|
| Doing Business As | COLES VILLAGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GEORGE IBRAHIM CEO 949-232-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY50435) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2018-09-12 |