Organization
NEELEY, INC
Active
Other names
North Lake Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY RICETTI (PHARMACY TECH/MAMAGER)
(707) 263-6192
Entity
Organization
Contact information
Practice address
5136 HILL RD E, LAKEPORT, CA 95453-6300
(707) 263-6192
(707) 263-7839
Mailing address
5136 HILL RD E, LAKEPORT, CA 95453-6300
(707) 263-6192
(707) 263-7839
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHA212400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHY57297
—
CA
Enumeration date
07/28/2006
Last updated
12/09/2021
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