Organization
BOULDER CREEK PHARMACY INC
Active
Other names
FELTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LOCATELLI RPH (OWNER)
(831) 338-2144
Entity
Organization
Contact information
Practice address
6240 HIGHWAY 9, FELTON, CA 95018-9713
(831) 335-4461
Mailing address
6240 HIGHWAY 9, FELTON, CA 95018-9713
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY39145
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501280
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA188600
—
CA
Enumeration date
01/17/2007
Last updated
12/02/2008
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