Provider Demographics
NPI:1821494576
Name:LA DRUGS INC
Entity Type:Organization
Organization Name:LA DRUGS INC
Other - Org Name:ATLANTIC DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:AMITKUMAR
Authorized Official - Middle Name:N
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:562-912-7940
Mailing Address - Street 1:4233 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-912-7940
Mailing Address - Fax:562-912-7944
Practice Address - Street 1:4233 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-912-7940
Practice Address - Fax:562-912-7944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 520203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56-53248OtherNCPDP NUMBER
CAPHY 52020OtherBOARD OF PHARMACY PERMIT NUMBER
CA1821494576Medicaid