Organization
BOULDER CREEK PHARMACY
Active
Other names
A Calif Corp
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E LOCATELLI RPH (PRESIDENT)
(831) 338-2241
Entity
Organization
Contact information
Practice address
13081 CENTRAL AVE, BOULDER CREEK, CA 95006
(831) 338-2144
(831) 338-0901
Mailing address
PO BOX 910, BOULDER CREEK, CA 95006
(831) 338-2144
(831) 338-0901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY30621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521650
NABP #
—
05
—
PHA306210
—
CA
Enumeration date
10/10/2006
Last updated
08/22/2020
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