Lac Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY47424 Issued in CA

Legal business name

LAC PHARMACIES INC

Doing business as

WATERMAN PHARMACY

Practice address

2150 N Waterman Ave
Ste 104
San Bernardino, CA 92404-4811

Phone

(909) 882-5800

Fax

(909) 882-3580

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Katherine Kar Chan, PHARMD

Title

Pres

Phone

(909) 882-5800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WATERMAN PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis Ho, PHARMD

  • Pharmacist
  • San Bernardino, CA
  • NPI 1427172600
  NPD (past)
• Linda Ngo, PHARMD

  • Pharmacist
  • San Bernardino, CA
  • NPI 1255618377
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1609988526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "STE 104",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-882-5800",
            "fax_number": "909-882-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "STE 104",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-882-5800",
            "fax_number": "909-882-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "KAR CHAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "909-882-5800",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0575918",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA431190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERMAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Araceli Antonia La Croix
• Louie Dela Pena Labial, PT
• Joseph Labita
• John Paul Labog
• Fernando G Labrada, D.C.
• Shannon Lacey Yerton
• Taja Yvette Marie Lacey
• Zava Lacey
• Mary Lacy
• Sebastian Lafo

• Community/Retail Pharmacy in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.