NPIMap

Organization Active NPI

Lucky Stores II LLC

  • Pharmacy
  • Oakland, CA
National Provider Identifier
1669419115
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY46944 Issued in CA
Legal business name
LUCKY STORES II LLC
Practice address
247 E 18TH St
Oakland, CA 94606-1728
Phone
(510) 272-9042
Fax
(510) 272-9257
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Lorenzo Torres
Title
New Store Enrollments
Phone
(847) 916-4463

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY46944 CA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

247 E 18TH St
Oakland, CA 94606-1728

Mailing address

247 E 18TH St
Oakland, CA 94606-1728

Other identifiers 1

IdentifierTypeStateIssuer
5614842OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • SAVON PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lucky Stores II LLC60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669419115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 E 18TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946061728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 E 18TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946061728",
            "telephone_number": "510-272-9042",
            "fax_number": "510-272-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKY STORES II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_title_or_position": "NEW STORE ENROLLMENTS",
        "authorized_official_telephone_number": "847-916-4463"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46944",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5614842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAVON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.