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STEVEN LANE GREEN PHARMACIST

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1871751990

Individual Registrant:
 STEVEN LANE GREEN PHARMACIST
Gender: M
Sole Proprietor

Location and contact information for practice:
14115 LAKERIDGE CIR  MAGALIA, CA 95954-9470 US
Tel: 530-873-0800  Fax: 530-873-8033

Contact information for business:
14115 LAKERIDGE CIR  MAGALIA, CA 95954-9470 US
Tel: 530-873-0800  Fax: 530-873-8033

Registration Information:
NPI: 1871751990
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CA36373

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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