Provider Demographics
NPI:1053312439
Name:DAK HEALTHCARE INC
Entity Type:Organization
Organization Name:DAK HEALTHCARE INC
Other - Org Name:986 PHARMACY#8009
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:THAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:626-456-4132
Mailing Address - Street 1:9209 COLIMA RD
Mailing Address - Street 2:STE 1100
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1800
Mailing Address - Country:US
Mailing Address - Phone:562-789-5852
Mailing Address - Fax:562-789-5854
Practice Address - Street 1:9209 COLIMA RD
Practice Address - Street 2:STE 1100
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1800
Practice Address - Country:US
Practice Address - Phone:562-789-5852
Practice Address - Fax:562-789-5854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X
CAPHY433073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2004661OtherPK
CA1053312439Medicaid
CAPHA433070Medicaid
4802220001Medicare NSC