NPIMap

Organization Active NPI

Lodi Memorial Hosptial Pharmacy West

  • Clinic Pharmacy
  • Lodi, CA
National Provider Identifier
1043633761
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
HSP37642 Issued in CA
Legal business name
LODI MEMORIAL HOSPTIAL PHARMACY WEST
Practice address
975 S Fairmont Ave
2415 W Vine #104
Lodi, CA 95240-5118
Phone
(209) 334-3411
Fax
(209) 333-3110
NPI assigned
Jan 31, 2014
Last updated
Jan 31, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
LODI MEMORIAL HOSPTIAL ASSOCIATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark Sey, REGISTERED PHAMRACIS
Title
Chief Admistrative Officer
Phone
(209) 339-7439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X HSP37642 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
2415 W Vine #104
Lodi, CA 95240-5118

Mailing address

2415 W Vilne #104
Lodi, CA 95240-5118
Phone (209) 334-3411

National Provider Directory

National Provider Directory
Tax ID family
Lodi Memorial Hosptial Pharmacy West9 organizations share this tax ID, including this one
Part of
Lodi Memorial Hosptial Pharmacy West

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2415 W Vine St
Ste 104
Lodi, CA 95242

975 S Fairmont Ave
#2415W
Lodi, CA 95240

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1043633761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 W VILNE #104",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411",
            "fax_number": "209-333-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "address_2": "2415 W VINE #104",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411",
            "fax_number": "209-333-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI MEMORIAL HOSPTIAL PHARMACY WEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LODI MEMORIAL HOSPTIAL ASSOCIATION INC",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "SEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF ADMISTRATIVE OFFICER",
        "authorized_official_telephone_number": "209-339-7439",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REGISTERED PHAMRACIS"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "HSP37642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.