Organization

LODI PHARMACY INC

Other Names:LODI PHARMACY

NPI Number1003000258

Practice Location

929 S CHEROKEE LN

LODI, CA, 95240-4304

Phone

(209) 365-7766

Fax

(209) 365-7733

Mailing Address

929 S CHEROKEE LN

LODI, CA, 952404304

Phone

(209) 365-7766

Fax

(209) 365-7733

Other Identifiers

2121631

Other (non-Medicare)

Issuer: PK

PHA499020

MEDICAID

State: CA

License Information

License Number

PHY49902

State: CA

Important Dates

Enumeration Date

August 30, 2007

Last Updated

October 20, 2014