Organization
LAKE HEALTH SERVICES, INC.
Active
Organization
LAKE HEALTH SERVICES, INC.
Active
Parent organization
LAKE HEALTH SERVICES, INC.
Other names
Lake Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE HEALTH SERVICES, INC.
Authorized official
DR. TIM NGUYEN PHARMD (PRESIDENT)
(925) 586-2112
Entity
Organization
Contact information
Practice address
18990 COYOTE VALLEY RD STE 2&3, HIDDEN VALLEY LAKE, CA 95467-8337
(707) 994-3141
Mailing address
PO BOX 7150, CLEARLAKE, CA 95422-7150
(707) 994-3141
(707) 994-7150
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
10/20/2020
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