Organization
PHARMAJO INC
Active
Other names
PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LUTZ (PRESIDENT)
(805) 492-2451
Entity
Organization
Contact information
Practice address
430 E AVENIDA DE LOS ARBOLES, SUITE 103, THOUSAND OAKS, CA 91360-3003
(805) 492-2451
(805) 492-7837
Mailing address
430 E AVENIDA DE LOS ARBOLES, SUITE 103, THOUSAND OAKS, CA 91360-3003
(805) 492-2451
(805) 492-7837
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY45917
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521840
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA459170
—
CA
Enumeration date
10/31/2006
Last updated
03/08/2012
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