Provider Demographics
NPI:1013380179
Name:MONARCH LLC
Entity Type:Organization
Organization Name:MONARCH LLC
Other - Org Name:MONARCH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-560-1042
Mailing Address - Street 1:707 W ROUTE 66
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4174
Mailing Address - Country:US
Mailing Address - Phone:626-335-0011
Mailing Address - Fax:626-335-1499
Practice Address - Street 1:707 W ROUTE 66 STE 103
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4175
Practice Address - Country:US
Practice Address - Phone:626-335-0011
Practice Address - Fax:626-335-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA538043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2155277OtherPK
CA1013380179Medicaid