MEDICARE: LA DRUGS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY 52020	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56-53248	OTHER	CA	NCPDP NUMBER
2	PHY 52020	OTHER	CA	BOARD OF PHARMACY PERMIT NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821494576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA DRUGS INC

Provider Business Mailing Address
First Line	:	4233 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807
Country	:	US
Telephone Number	:	562-912-7940
Fax Number	:	562-912-7944

Provider Business Practice Location Address
First Line	:	4233 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807
Country	:	US
Telephone Number	:	562-912-7940
Fax Number	:	562-912-7944

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

Provider Enumeration Date	:	11/07/2014
Last Update Date	:	01/18/2022

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Directions to “LA DRUGS INC ” Practice Location

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