National Provider Identifier Database

BOULDER CREEK PHARMACY
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

BOULDER CREEK PHARMACY
13081 CENTRAL AVE
BOULDER CREEK, CA95006
Phone: 831-338-2144
Fax: 831-338-0901
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for BOULDER CREEK PHARMACY

NPI Number 1629165584
Legal business name
LBN
BOULDER CREEK PHARMACY
Authorized official ROBERT LOCATELLI - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 10/10/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: PHY30621
  • CA Medicaid: PHA306210
  • Other: 0521650 NABP #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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