Organization
LISA FAMILY PHARMACY INC
Active
Other names
LISA FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA S HOHENTHANER PHARM D (PRESIDENT/PIC)
(530) 873-0460
Entity
Organization
Contact information
Practice address
14137 LAKERIDGE CT., MAGALIA, CA 95954-0970
(530) 873-0460
(530) 873-0703
Mailing address
P.O. BOX 970, MAGALIA, CA 95954-0970
(530) 873-0460
(530) 873-0703
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY 51582
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 51582
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0553962
NCPDP
CA
01
—
1801966890
MEDI-CAL PROVIDER
CA
01
—
PHY 51582
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
11/08/2006
Last updated
10/16/2013
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