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SHASTA LAKE DRUG STORE
NPI 1568803260
Pharmacy - Community/Retail Pharmacy in Shasta Lake, CA

Active since July 10, 2013
4222 SHASTA DAM BLVD, SHASTA LAKE, CA 96019(530) 275-2700(530) 275-2800 Get Directions Write a Review

NPPES record last updated: August 1, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Shasta Lake Drug Store NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA LAKE DRUG STORE (NPI 1568803260) is a healthcare organization registered as a community/retail pharmacy in Shasta Lake, California and active in the NPI registry since July 2013. The organization lists Jodi Walsh, Officer/secretary, as its authorized official.

NPPES Registry Identity

NPI1568803260
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSHASTA LAKE DRUG STORE INC
Location Address4222 SHASTA DAM BLVDShasta Lake, CA 96019-9422
Mailing AddressPo Box 991179Redding, CA 96099-1179 · (530) 275-2700 · Fax (530) 275-2800
Phone(530) 275-2700
Fax(530) 275-2800
Organization SubpartNo
Authorized OfficialJodi WalshOfficer/secretary · (530) 339-1445
Enumeration DateJuly 10, 2013
Last NPPES UpdateAugust 1, 2013
✔ NPI 1568803260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · 51277
Definition
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.
Also ListedPharmacyTaxonomy 333600000X
4222 SHASTA DAM BLVD, Shasta Lake, CA 96019
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Other Names 1

Doing Business AsShasta Lake Drug Store

Other Identifiers 2

MedicaidPHA512770CA
Other2138099Pk

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shasta Lake Drug Store Inc's NPI number?

The NPI number for Shasta Lake Drug Store Inc is 1568803260. It was assigned to this organization in the NPPES registry on July 10, 2013. The provider is doing business as Shasta Lake Drug Store.

Where is Shasta Lake Drug Store Inc located?

Shasta Lake Drug Store Inc is located at 4222 Shasta Dam Blvd, Shasta Lake, CA 96019. The listed phone number is (530) 275-2700.

What is Shasta Lake Drug Store Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Shasta Lake Drug Store Inc was last updated on August 1, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.