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Organization

LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD

Active
Other names
a. LPCH Children's Home Pharmacy b. Stanford Home Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MARISA NG PHARM.D. (ASST. DIRECTOR OF PHARMACY)
(650) 497-8391
Entity
Organization

Contact information

Practice address
4600 BOHANNON DR, SUITE 105, MENLO PARK, CA 94025-1034
(650) 497-8316
(650) 497-8320
Mailing address
4600 BOHANNON DR, SUITE 105, MENLO PARK, CA 94025-1034
(650) 497-8316
(650) 497-8320

Taxonomy

Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003751
BLUE CROSS PROVIDER#
01
0549381
NABP
01
FP0549381
BLUE SHIELD PHARM
05
PHA 407800
CA
01
ZZZ41694Z
BLUE SHIELD HOME INFUSION
Enumeration date
08/04/2006
Last updated
08/05/2019
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