Organization
LUCKY STORES II LLC
Active
Other names
SAVON DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO TORRES (NEW STORE ENROLLMENTS)
(847) 916-4463
Entity
Organization
Contact information
Practice address
4708 MANZANITA AVE, CARMICHAEL, CA 95608-0823
(916) 979-9100
(916) 979-9861
Mailing address
4708 MANZANITA AVE, CARMICHAEL, CA 95608-0823
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY43410
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0577392
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/01/2006
Last updated
09/11/2025
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