Organization
LUCERNE PHARMACY INC
Active
Other names
LUCERNE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLAN SHEPHERD RPH (CEO AND PIC)
(707) 274-6643
Entity
Organization
Contact information
Practice address
6244 E HIGHWAY 20, LUCERNE, CA 95458-1316
(707) 274-6643
(707) 274-2469
Mailing address
PO BOX 1316, LUCERNE, CA 95458-1316
(707) 274-6643
(707) 274-2469
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46594
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1989861
PK
—
Enumeration date
11/20/2006
Last updated
03/03/2016
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