Organization Name: | MOTHER LODE PHARMACIES, INC. |
NPI Number: | 1891876918 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAYMOND L GUIDI (PRESIDENT) |
Mailing Address: | 64 E. Saint Charles St San Andreas |
State: | CA US |
Postal Code: | 952490009 |
Phone Number: | 2097543595 |
Fax Number: | 2097545387 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 417030 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |