MEDICARE: L.M.CALDWELL PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PHY30911	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0547161	OTHER	CA	NCPDP

General Provider Information

NPI Number	:	1093700882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L.M.CALDWELL PHARMACIST

Provider Business Mailing Address
First Line	:	1509 STATE ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2513
Country	:	US
Telephone Number	:	805-965-4528
Fax Number	:	805-966-1844

Provider Business Practice Location Address
First Line	:	1509 STATE ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2513
Country	:	US
Telephone Number	:	805-965-4528
Fax Number	:	805-966-1844

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PETER CRAIG CALDWELL
Credential	:	PD
Telephone Number	:	805-965-4528

Provider Enumeration Date	:	09/17/2005
Last Update Date	:	08/22/2020

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