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General NPI Number Information
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NPI Number | 1487885604
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Entity Type | Organization
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Legal Business Name | LG PHARMACIES, LLC
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 1620 HIGH ST SUITE 2B
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City | OAKLAND
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State | CA
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Zip | 94601-4536
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Country | US
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Telephone | 650-842-8790
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Fax | 510-842-8789
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Provider Business Mailing Address
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Address Line | 1620 HIGH ST SUITE 2B
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City | OAKLAND
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State | CA
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Zip | 94601-4536
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Country | US
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Telephone | 650-842-8790
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Fax | 510-842-8789
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Authorized Official
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Title or Position | OWNER/LLC MANAGER
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Name | MR. URIEL CHAVEZ
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Credential |
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Telephone | 510-842-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50030
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License Number State | CA
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