MEDICARE: LION PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY 52544	CA

General Provider Information

NPI Number	:	1780062547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LION PHARMACY INC

Provider Business Mailing Address
First Line	:	2857 SENTER RD STE A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95111-1100
Country	:	US
Telephone Number	:	408-784-3921
Fax Number	:

Provider Business Practice Location Address
First Line	:	2857 SENTER RD STE A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95111-1100
Country	:	US
Telephone Number	:	408-784-3921
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	CHI MAI
Credential	:	PHARMD
Telephone Number	:	408-886-0331

Provider Enumeration Date	:	05/13/2015
Last Update Date	:	05/13/2015

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Directions to “LION PHARMACY INC ” Practice Location

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