Organization
LIFESCRIPT PHARMACY
Active
Other names
LifeScript Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH DALAVAI (CEO)
(510) 878-7562
Entity
Organization
Contact information
Practice address
39039 PASEO PADRE PKWY STE 201, FREMONT, CA 94538-1618
(510) 967-7951
Mailing address
39039 PASEO PADRE PKWY STE 201, FREMONT, CA 94538-1618
(510) 967-7951
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
54286
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160217
PK
—
Enumeration date
05/12/2016
Last updated
04/17/2019
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