Organization
LIDO PHARMACY LLC
Active
Other names
NEWPORT LIDO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN THOMAS HOM PHARM D (MANAGING MEMBER)
(949) 764-6580
Entity
Organization
Contact information
Practice address
351 HOSPITAL RD STE 107, NEWPORT BEACH, CA 92663-3503
(949) 764-6580
(949) 764-6581
Mailing address
351 HOSPITAL RD STE 107, NEWPORT BEACH, CA 92663-3503
(949) 764-6580
(949) 764-6581
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY60035
BOARD OF PHARMACY
CA
Enumeration date
03/02/2007
Last updated
10/29/2024
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