Lodi Drug Company, Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHY20652 Issued in CA

Legal business name

LODI DRUG COMPANY, INC

Practice address

115 Lakewood Mall
Lodi, CA 95242-2963

Phone

(209) 368-6636

NPI assigned

Dec 11, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Nick Spanos Jr., R.PH.

Title

Owner

Phone

(209) 339-8624

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakewood Drugs Former legal business name

Locations

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

{
    "created_epoch": "1134259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285619460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LAKEWOOD MALL",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952422963",
            "telephone_number": "209-368-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LAKEWOOD MALL",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952422963",
            "telephone_number": "209-368-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI DRUG COMPANY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPANOS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-339-8624",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY20652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA206520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Drugs",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Lodi Dental Group
• Lodi Health
• Lodi Kids Dentist a Professional Dental Corporation (Lodi Kids Dentist A Professional Dental Corporation DBA Lodi Kidz Dentist)
• Lodi Lifestyle Medicine & Surgery, Professional Corporation
• Lodi Memorial Hospital Association Inc (Lodi Health Pharmacy West)
• Lodi Memorial Hospital Association Inc (Lodi Memorial Hospital Home Health Agency)

• Pharmacist in Lodi, CA
• Providers in Lodi, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.