Organization
LUCKY STORES II LLC
Active
Other names
SAVON DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
291 MCCRAY ST, HOLLISTER, CA 95023-4094
(831) 634-1887
(831) 634-1897
Mailing address
291 MCCRAY ST, HOLLISTER, CA 95023-4094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY42022
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0549886
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/02/2006
Last updated
09/11/2025
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