Provider Demographics
NPI:1053166892
Name:DILDAX CORPORATION
Entity type:Organization
Organization Name:DILDAX CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/ SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:562-925-6505
Mailing Address - Street 1:16900 BELLFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5904
Mailing Address - Country:US
Mailing Address - Phone:562-925-6505
Mailing Address - Fax:562-925-8786
Practice Address - Street 1:16900 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5904
Practice Address - Country:US
Practice Address - Phone:562-925-6505
Practice Address - Fax:562-925-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy