Healthcare Provider Details

I. General information

NPI: 1255374054
Provider Name (Legal Business Name): LAGUNA HONDA HOSPITAL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 LAGUNA HONDA BLVD
SAN FRANCISCO CA
94116-1411
US

IV. Provider business mailing address

375 LAGUNA HONDA BLVD
SAN FRANCISCO CA
94116-1411
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2300
  • Fax: 415-759-6017
Mailing address:
  • Phone: 415-759-2300
  • Fax: 415-759-6017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberHPE4323
License Number StateCA

VIII. Authorized Official

Name: MICHELLE FOUTS
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 415-682-5782