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
844 BLOSSOM HILL RD, SAN JOSE, CA 95123-2725
(408) 972-2862
(408) 972-2866
Mailing address
844 BLOSSOM HILL RD, SAN JOSE, CA 95123-2725
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY40023
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0550776
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/02/2006
Last updated
09/11/2025
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