Organization
LAKE ARROWHEAD VILLAGE PHARMACY
Active
Other names
LAKE ARROWHEAD VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BLAIN (PRESIDENT)
(909) 336-0120
Entity
Organization
Contact information
Practice address
28200 ST HWY 189, LAKE ARROWHEAD, CA 92352-9700
(909) 336-0120
(909) 336-0140
Mailing address
PO BOX 2945, LAKE ARROWHEAD, CA 92352-2945
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0588600
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA460400
—
CA
Enumeration date
11/29/2006
Last updated
07/25/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us