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General NPI Number Information
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NPI Number | 1548347180
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Entity Type | Organization
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Legal Business Name | LIMA'S PROFESSIONAL PHARMACY, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 2097 HARRISON AVE
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City | EUREKA
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State | CA
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Zip | 95501-3211
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Country | US
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Telephone | 707-441-8500
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Fax | 707-443-7608
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Provider Business Mailing Address
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Address Line | 2097 HARRISON AVE
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City | EUREKA
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State | CA
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Zip | 95501-3211
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Country | US
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Telephone | 707-441-8500
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Fax | 707-443-7608
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT BREDE LIMA
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Credential | R.PH.
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Telephone | 707-441-8530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY43124
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 99030
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY43124
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License Number State | CA
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