Provider Demographics
NPI:1982605663
Name:GOLDEN DRUGS CO INC
Entity Type:Organization
Organization Name:GOLDEN DRUGS CO INC
Other - Org Name:GOLDEN DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:REZNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-234-9956
Mailing Address - Street 1:PO BOX 111318
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90011-9318
Mailing Address - Country:US
Mailing Address - Phone:323-234-9956
Mailing Address - Fax:323-234-0060
Practice Address - Street 1:4128 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2221
Practice Address - Country:US
Practice Address - Phone:323-234-9956
Practice Address - Fax:323-234-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY46438333600000X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0535801OtherNABP
CA4882780001Medicare NSC