# LIFESCRIPT PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeScript Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558717199
- **Authorized official:** JOSEPH DALAVAI (CEO)
- **Authorized official phone:** (510) 878-7562

## Contact information

- **Practice address:** 39039 PASEO PADRE PKWY STE 201, FREMONT, CA 94538-1618
- **Practice address phone:** (510) 967-7951
- **Mailing address:** 39039 PASEO PADRE PKWY STE 201, FREMONT, CA 94538-1618
- **Mailing address phone:** (510) 967-7951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 54286 | CA | Yes |

## Other

- **Enumeration date:** 05/12/2016
- **Last updated:** 04/17/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2160217 | PK | — |