# SENIOR CARE PHARMACY OF THE WEST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SENIOR CARE PHARMACY OF THE WEST, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568746410
- **Legal business name:** SENIOR CARE PHARMACY OF THE WEST, LLC
- **Authorized official:** MR. GLEN KEITH ANDERSON RPH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (801) 410-1980

## Contact information

- **Practice address:** 927 INDUSTRIAL WAY, LODI, CA 95240-3105
- **Practice address phone:** (888) 915-3566
- **Practice address fax:** (888) 692-5991
- **Mailing address:** 927 INDUSTRIAL WAY, LODI, CA 95240-3105
- **Mailing address phone:** (888) 915-3566
- **Mailing address fax:** (888) 692-5991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/10/2011
- **Last updated:** 10/10/2011