Organization
COSTCO 1042
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAKSHMI GANGIREDLA RPH (PHARMACY/MANAGER)
(650) 568-4049
Entity
Organization
Contact information
Practice address
2300 MIDDLEFIELD RD, REDWOOD CITY, CA 94063-2854
(650) 568-4049
Mailing address
2300 MIDDLEFIELD RD, REDWOOD CITY, CA 94063-2854
(650) 568-4049
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
56490
CA
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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