Organization Active NPI

Lucky Stores II LLC

  • Community/Retail Pharmacy
  • San Jose, CA
National Provider Identifier
1841237278
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LUCKY STORES II LLC
Practice address
565 W Capitol Expy
San Jose, CA 95136-3914
Phone
(408) 267-6828
Fax
(408) 267-6907
NPI assigned
Jun 2, 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 PHY41476 CA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

565 W Capitol Expy
San Jose, CA 95136-3914

Mailing address

565 W Capitol Expy
San Jose, CA 95136-3914

Other identifiers 1

IdentifierTypeStateIssuer
0537108OtherOTHER 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 23

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

View all 23

Locations

565 W Capitol Expy
San Jose, CA 95136
Phone (408) 267-6828

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1841237278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 W CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951363914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 W CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951363914",
            "telephone_number": "408-267-6828",
            "fax_number": "408-267-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKY STORES II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "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": "PHY41476",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0537108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAVON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, 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.