# LUMBAR STORE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609359371
- **Authorized official:** KATHLEEN GUC (CEO)
- **Authorized official phone:** (844) 206-2272

## Contact information

- **Practice address:** 1452 N VASCO RD STE 165, LIVERMORE, CA 94551-9213
- **Practice address phone:** (844) 206-2272
- **Mailing address:** 1452 N VASCO RD STE 165, LIVERMORE, CA 94551-9213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 09/10/2018
- **Last updated:** 09/10/2018