Provider Demographics
NPI:1912942236
Name:HERBS UNITED DRUGS INC
Entity Type:Organization
Organization Name:HERBS UNITED DRUGS INC
Other - Org Name:PHARMACY DEPOT UNITED DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-677-0212
Mailing Address - Street 1:4903 W PICO BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-4262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4903 W PICO BLVD
Practice Address - Street 2:STE 202
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-4262
Practice Address - Country:US
Practice Address - Phone:323-965-9885
Practice Address - Fax:323-924-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY43258333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0575653OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CAPHA432580Medicaid