Provider Demographics
NPI:1053927921
Name:LU & WEBER CORPORATION
Entity type:Organization
Organization Name:LU & WEBER CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:LU
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-590-3620
Mailing Address - Street 1:10521 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1128
Mailing Address - Country:US
Mailing Address - Phone:714-590-3620
Mailing Address - Fax:
Practice Address - Street 1:10521 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1128
Practice Address - Country:US
Practice Address - Phone:714-590-3620
Practice Address - Fax:714-590-3628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA439860Medicaid