NPIMap

Organization Active NPI

Boulder Creek Pharmacy

  • Pharmacy
  • Boulder Creek, CA
National Provider Identifier
1629165584
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY30621 Issued in CA
Legal business name
BOULDER CREEK PHARMACY
Practice address
13081 Central Ave
Boulder Creek, CA 95006
Phone
(831) 338-2144
Fax
(831) 338-0901
NPI assigned
Oct 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert E Locatelli, RPH
Title
President
Phone
(831) 338-2241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY30621 CA Primary

Addresses

Primary practice location

13081 Central Ave
Boulder Creek, CA 95006

Mailing address

PO Box 910
Boulder Creek, CA 95006
Phone (831) 338-2144

Other names 1

  • A Calif Corp Other name

National Provider Directory

National Provider Directory
Tax ID family
A Calif Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

13081 Central Ave
Boulder Creek, CA 95006
Phone (831) 338-2144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629165584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "95006",
            "telephone_number": "831-338-2144",
            "fax_number": "831-338-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13081 CENTRAL AVE",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "95006",
            "telephone_number": "831-338-2144",
            "fax_number": "831-338-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER CREEK PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCATELLI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-338-2241",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY30621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Calif Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boulder Creek, CA

Sources for this page

  • 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.