Provider Demographics
NPI:1427147073
Name:PALU INC
Entity type:Organization
Organization Name:PALU INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SRILAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAINALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-301-4863
Mailing Address - Street 1:850 S ATLANTIC BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4730
Mailing Address - Country:US
Mailing Address - Phone:626-308-9227
Mailing Address - Fax:626-308-2067
Practice Address - Street 1:850 S ATLANTIC BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4730
Practice Address - Country:US
Practice Address - Phone:626-308-9227
Practice Address - Fax:626-308-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X
CAPHY444013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2002305OtherPK
CA0574928Medicaid
1285610002Medicare NSC