Organization
LUCKY STORES II LLC
Active
Other names
SAVON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
2175 GRANT RD, LOS ALTOS, CA 94024-6952
(650) 969-0772
(650) 969-1887
Mailing address
2175 GRANT RD, LOS ALTOS, CA 94024-6952
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY39208
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0534948
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/01/2006
Last updated
09/11/2025
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