LODI PHARMACY (LODI PHARMACY INC) NPI 1003000258
Pharmacy (Community/Retail Pharmacy) in Lodi, CA
About LODI PHARMACY (LODI PHARMACY INC)
Lodi Pharmacy (lodi Pharmacy Inc) is a provider established in Lodi, California specializing in pharmacy. The NPI number of Lodi Pharmacy (lodi Pharmacy Inc) is 1003000258 and was assigned on August 2007. The practitioner's primary taxonomy code is 3336C0003X with license number PHY49902 (CA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Lodi Pharmacy.
The authorized official of this NPI record is Jaspal Samra (Director)
| NPI | 1003000258 |
| Provider Name | LODI PHARMACY (LODI PHARMACY INC) |
| Provider Location Address | 929 S CHEROKEE LN LODI, CA 95240 |
| Provider Mailing Address | 929 S CHEROKEE LN LODI, CA 95240 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Other Organization Name | LODI PHARMACY |
| Other Name Type | Doing Business As (3) |
| Enumeration Date | 08-30-2007 |
| Last Update Date | 10-20-2014 |
Primary Taxonomy
| Taxonomy Code | 3336C0003X |
| 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. |
Business Address
LODI PHARMACY (LODI PHARMACY INC)
929 S CHEROKEE LN
LODI, CA
ZIP 95240
Phone: (209) 365-7766
Fax: (209) 365-7733
Mailing Address
LODI PHARMACY (LODI PHARMACY INC)
929 S CHEROKEE LN
LODI, CA
ZIP 95240
Phone: (209) 365-7766
Fax: (209) 365-7733
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 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
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
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart 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.
Provider Other Organization Name
The other organization name is 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. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
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.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.