NPIMap

Organization Active NPI

Lodi Health

  • Pharmacy Technician
  • Lodi, CA
National Provider Identifier
1972910743
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
59860 Issued in CA
Legal business name
LODI HEALTH
Practice address
2415 W Vine St
Lodi, CA 95242-3731
Phone
(209) 333-3009
Fax
(209) 333-3110
NPI assigned
Jul 14, 2014
Last updated
Jul 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Mr. Gary A Airolla
Title
Pharmacist in Charge
Phone
(209) 333-3060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 59860 CA Primary

Addresses

Primary practice location

2415 W Vine St
Lodi, CA 95242-3731

Mailing address

2415 W Vine St
Lodi, CA 95242-3731
Phone (209) 333-3009

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0885857Adventist Health Lodi Memorial2415 W Vine St Ste 103, Lodi, CA 95242Certificate of waiverSep 16, 2027
05D2035089Adventist Health Lodi Memorial2415 W Vine St Ste 106, Lodi, CA 95242Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Lodi Memorial Hosptial Pharmacy West9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

2415 W Vine St
Lodi, CA 95242
Phone (209) 333-3009

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1972910743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 W VINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423731",
            "telephone_number": "209-333-3009",
            "fax_number": "209-333-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 W VINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423731",
            "telephone_number": "209-333-3009",
            "fax_number": "209-333-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "AIROLLA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "209-333-3060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "59860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.