Organization
FRED AND LUCY INC
Active
Other names
RX 2 GO
Organization subpart
No
Provider details
NPI number
Authorized official
FRED LEE R PH (OWNER)
(909) 989-2002
Entity
Organization
Contact information
Practice address
9700 19TH ST, SUITE A, RANCHO CUCAMONGA, CA 91737-3538
(909) 989-2002
(909) 989-1182
Mailing address
9700 19TH ST, SUITE A, RANCHO CUCAMONGA, CA 91737-3538
(909) 989-2002
(909) 989-1182
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
41665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0579562
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA416650
—
CA
Enumeration date
01/30/2007
Last updated
11/18/2011
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