Organization
NEELEY FAMILY, INC
Active
Other names
North Lake Medical Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL NEELEY (OWNER)
(707) 263-1328
Entity
Organization
Contact information
Practice address
347 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-1328
(707) 263-0864
Mailing address
347 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-1328
(707) 263-0864
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY412710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA412710
—
CA
Enumeration date
07/10/2006
Last updated
07/24/2024
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