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General NPI Number Information
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NPI Number | 1487651907
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Entity Type | Organization
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Legal Business Name | SAMARITAN MEDICAL CENTER PHARMACY
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 2505 SAMARITAN DR
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City | SAN JOSE
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State | CA
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Zip | 95124-4006
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Country | US
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Telephone | 408-356-7111
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Fax | 408-358-6259
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Provider Business Mailing Address
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Address Line | 2505 SAMARITAN DR
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City | SAN JOSE
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State | CA
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Zip | 95124-4006
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Country | US
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Telephone | 408-356-7111
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Fax | 408-358-6259
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | MR. MICHAEL LAM
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Credential | RPH
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Telephone | 408-356-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY33985
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License Number State | CA
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