Healthcare Provider Details

I. General information

NPI: 1972823086
Provider Name (Legal Business Name): LORIE GARLICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 STOCKTON BLVD
SACRAMENTO CA
95824-1612
US

IV. Provider business mailing address

5610 STOCKTON BLVD
SACRAMENTO CA
95824-1612
US

V. Phone/Fax

Practice location:
  • Phone: 916-737-0260
  • Fax: 916-737-0269
Mailing address:
  • Phone: 916-737-0260
  • Fax: 916-737-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number40211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: