Healthcare Provider Details

I. General information

NPI: 1821494576
Provider Name (Legal Business Name): LA DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4233 ATLANTIC AVE
LONG BEACH CA
90807
US

IV. Provider business mailing address

4233 ATLANTIC AVE
LONG BEACH CA
90807
US

V. Phone/Fax

Practice location:
  • Phone: 562-912-7940
  • Fax: 562-912-7944
Mailing address:
  • Phone: 562-912-7940
  • Fax: 562-912-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY 52020
License Number StateCA

VIII. Authorized Official

Name: MR. AMITKUMAR N THAKKAR
Title or Position: PRESIDENT/PIC
Credential: PHARM D
Phone: 562-912-7940