Waterfront Pharmacy Ltc Llc

LBN: Waterfront Pharmacy Ltc Llc
Waterfront Pharmacy Ltc Llc is an health care organization with primary practice located at 123 S Commerce St Ste A , Stockton CA 95202-2837. The organization recently has only one registered license in Suppliers / Long Term Care Pharmacy, which is considered as the primary health care specialty. Waterfront Pharmacy Ltc Llc can be contacted via phone (209) 298-1715, or through Kadiyala, Chandra via phone (509) 392-1958.

Contact Information

Primary practice address
123 S Commerce St Ste A Stockton CA 95202-2837
Phone: (209) 298-1715
Fax: (559) 369-2408
Website:
Map and Directions
Authorized official contact:
Name: Kadiyala, Chandra
Phone: (509) 392-1958

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1114696382
LBN Legal business name Waterfront Pharmacy Ltc Llc
DBA Doing business as
Authorized official Kadiyala, Chandra
Entity Organization
Organization subpart 1 No
Enumeration date Sep 9th, 2021
Last updated Apr 18th, 2024 - about 2 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 1114696382 NPPES
California Other PHY58030 PHARMACY LICENSE

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