Organization
BCRX INC
Active
Other names
BOULDER CREEK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LINDBERG PHARM.D. (PRESIDENT)
(831) 338-2144
Entity
Organization
Contact information
Practice address
13081 CENTRAL AVE, BOULDER CREEK, CA 95006-9119
(831) 338-2144
Mailing address
13081 CENTRAL AVE, BOULDER CREEK, CA 95006-9119
(831) 338-2144
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY56168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY56168
CA BOARD OF PHARMACY LICENSE
CA
Enumeration date
08/08/2018
Last updated
03/07/2023
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