LODI PHARMACY INC NPI 1003000258

Pharmacy (Community/Retail Pharmacy) in Lodi, CA

About LODI PHARMACY INC

Lodi Pharmacy Inc is a provider in Lodi, CA. The NPI number assigned to this provider is 1003000258. The practitioner's primary taxonomy code is Pharmacy (3336C0003X). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Lodi Pharmacy.

NPI	1003000258 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	LODI PHARMACY INC
Provider Location Address	929 S CHEROKEE LN LODI, CA 95240 Provider location address The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address	929 S CHEROKEE LN LODI, CA 95240 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity type code The code describing the type of health care provider that is being assigned an NPI. Codes are: 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?	N/A
Is Organization Subpart?	No What is a subpart? Subparts are the components and separate physical locations of organization health care providers. Examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization Name	LODI PHARMACY Provider other organization name The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; : 5 = other.
Other Name Type	Doing Business As (3)
Enumeration Date	08-30-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	10-20-2014 Last update date The date that a record was last updated or changed.

Business Address

LODI PHARMACY INC
929 S CHEROKEE LN
LODI, CA
ZIP 95240
Phone: (209) 365-7766
Fax: (209) 365-7733

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Mailing Address

LODI PHARMACY INC
929 S CHEROKEE LN
LODI, CA
ZIP 95240
Phone: (209) 365-7766
Fax: (209) 365-7733

Primary Taxonomy

Taxonomy Code	3336C0003X Primary Taxonomy Code The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Classification	Pharmacy
Type	Suppliers
Specialization	Community/Retail Pharmacy
License No.	PHY49902
License State	CA
Taxonomy Description	A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Authorized Official

Authorized Official Name	JASPAL SAMRA Authorized official name The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official Title	DIRECTOR
Authorized Official Phone	(209) 365-7788

Additional Identifiers

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
2121631	OTHER (01)
PHA499020	MEDICAID (05)	CA

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