Organization
LAC PHARMACIES INC
Active
Other names
WATERMAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE KAR CHAN PHARMD (PRES)
(909) 882-5800
Entity
Organization
Contact information
Practice address
2150 N WATERMAN AVE, STE 104, SAN BERNARDINO, CA 92404-4811
(909) 882-5800
(909) 882-3580
Mailing address
2150 N WATERMAN AVE, STE 104, SAN BERNARDINO, CA 92404-4811
(909) 882-5800
(909) 882-3580
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47424
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0575918
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA431190
—
CA
Enumeration date
08/31/2006
Last updated
03/03/2010
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