Organization
ARCHANA CORPORATION
Active
Other names
Leo's Lakeside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH RAKHOLIA B. PHARM (PRESIDENT)
(619) 287-7697
Entity
Organization
Contact information
Practice address
9943 MAINE AVE, LAKESIDE, CA 92040-3107
(619) 443-1013
(619) 443-8517
Mailing address
9943 MAINE AVE, LAKESIDE, CA 92040-3107
(619) 443-1013
(619) 443-8517
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50422
CA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811048069 03
—
CA
01
—
2127309
PK
—
Enumeration date
01/15/2007
Last updated
04/05/2017
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