Active NPI
Palu Inc
Doing business as Marina Pharmacy
- Community/Retail Pharmacy
- Marina del Rey, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 51786
- Legal business name
- PALU INC
- Doing business as
- Marina Pharmacy
- Practice address
- 4726 Lincoln Blvd
Marina del Rey, CA 90292-6902 - Phone
- (310) 301-4863
- Fax
- (310) 301-4865
- NPI assigned
- Jul 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nainala Srilakshmi
- Title
- Pic
- Phone
- (310) 301-4863
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 51786 | CA | Primary |
Addresses
Primary practice location
4726 Lincoln Blvd
Marina del Rey, CA 90292-6902
Mailing address
4726 Lincoln Blvd
Marina del Rey, CA 90292-6902
Phone (310) 301-4863
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0532463 | Medicaid | CA | |
| 2144099 | Other | PK |
Other names 1
- Marina Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221109003313 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 4789082595 | Practice locations: Marina del Rey, CA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Monterey Park Professional Pharmacy
- Community/Retail Pharmacy
- Monterey Park, CA
- NPI 1427147073
4789082595
National Provider Directory
National Provider DirectoryLocations
4644 Lincoln Blvd
Ste 100
Marina del Rey, CA 90292
4726 Lincoln Blvd
Marina del Rey, CA 90292
Phone (310) 301-4863
4724 Lincoln Blvd
Marina del Rey, CA 90292
Phone (310) 301-4863
4644 Lincoln Blvd
Ste 103110
Marina del Rey, CA 90292
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Marina del Rey, CA
- NPI 1437976487
-
- Pharmacist
- Manhattan Beach, CA
- NPI 1619595881
-
- Pharmacist
- Monterey Park, CA
- NPI 1891145405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725321600000",
"number": "1881611598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4726 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926902",
"telephone_number": "310-301-4863",
"fax_number": "310-301-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4726 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926902",
"telephone_number": "310-301-4863",
"fax_number": "310-301-4865"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALU INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A",
"authorized_official_last_name": "SRILAKSHMI",
"authorized_official_first_name": "NAINALA",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "310-301-4863"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "51786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0532463",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2144099",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Marina Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Marina Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.