Lake Health Services, NPI 1770580268
Community/Retail Pharmacy in Clearlake, CA, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1770580268
NPI Entity Type Organization
Provider Name Lake Health Services
Doing Business As
Subpart of Organization Lake Health Services
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 15230 Lakeshore Dr, Clearlake, CA, US
Provider Mailing Address Po Box 6376, Clearlake, CA, US, 954227150
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name PHARMD Tim Nguyen
Official Position PRESIDENT
Phone 925-586-2112

Primary Taxonomy

Taxonomy Code

3336C0003X

Taxonomy Name Community/Retail Pharmacy
Classification

Pharmacy

Group

Suppliers

License No. PHY55420
License State CA
Description A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Other Organization Name

Lake Pharmacy
Doing Business As

Business Address

Lake Health Services
15230 Lakeshore Dr

Clearlake, CA, US

Phone: 707-994-3141
Fax: 707-994-7150

Mailing Address

Lake Health Services
Po Box 6376
Clearlake, CA, US
ZIP 954227150
Phone: 707-994-3141

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

3336L0003X

Suppliers

Pharmacy

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
2001004 PK 01
PHA471230 CA MEDICAID 05

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