<Unavail>

LBN: Golden State Pharmacy
<Unavail> is an health care organization with primary practice located at 1617 N California St Ste 1F , Stockton CA 95204-6117. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Golden State Pharmacy can be contacted via phone (209) 420-1720, or through Gonzalez, Jorge E. via phone (209) 420-1720.

Contact Information

Primary practice address
1617 N California St Ste 1F Stockton CA 95204-6117
Phone: (209) 420-1720
Fax: (209) 227-7377
Website:
Map and Directions
Authorized official contact:
Name: Gonzalez, Jorge E.
Phone: (209) 420-1720

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 46048 California

Profile Details

NPI number 1437641115
LBN Legal business name Golden State Pharmacy
DBA Doing business as <Unavail>
Authorized official Gonzalez, Jorge E.
Entity Organization
Organization subpart 1 No
Enumeration date May 30th, 2018
Last updated Jun 7th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437641115 NPPES
California MEDICAID 4814941

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