Healthcare Provider Details

I. General information

NPI: 1326873795
Provider Name (Legal Business Name): COUNTY OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 MIDDLEFIELD RD # 300
PALO ALTO CA
94303-4753
US

IV. Provider business mailing address

777 TURNER DR, SUITE 330
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 650-843-0626
  • Fax:
Mailing address:
  • Phone: 408-885-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL E LORENZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 408-885-4010