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General NPI Number Information
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NPI Number | 1407864374
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Entity Type | Organization
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Legal Business Name | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 4600 BOHANNON DR SUITE 105
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City | MENLO PARK
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State | CA
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Zip | 94025-1034
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Country | US
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Telephone | 650-497-8316
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Fax | 650-497-8320
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Provider Business Mailing Address
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Address Line | 4600 BOHANNON DR SUITE 105
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City | MENLO PARK
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State | CA
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Zip | 94025-1034
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Country | US
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Telephone | 650-497-8316
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Fax | 650-497-8320
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Authorized Official
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Title or Position | ASST. DIRECTOR OF PHARMACY
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Name | MARISA NG
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Credential | PHARM.D.
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Telephone | 650-497-8391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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