Organization
ARCHANA CORPORATION
Active
Other names
LEO'S LAKESIDE PHARMACY-LTC
Organization subpart
No
Provider details
NPI number
Authorized official
RAJESH B ZALAVADIYA RPH (VICE PRESIDENT)
(619) 443-1013
Entity
Organization
Contact information
Practice address
9943 MAINE AVE, LAKESIDE, CA 92040-3107
(619) 443-1013
(619) 443-8517
Mailing address
9943 MAINE AVE, LAKESIDE, CA 92040-3107
(619) 443-1013
(619) 443-8517
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811048069
—
CA
Enumeration date
07/16/2021
Last updated
07/16/2021
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