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Contact Information

BOULDER CREEK PHARMACY
13081 CENTRAL AVE
BOULDER CREEK, CA95006
 Phone: 831-338-2144
 Fax: 831-338-0901
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BOULDER CREEK PHARMACY

NPI # 1629165584
LBN Legal business name BOULDER CREEK PHARMACY
Authorized official ROBERT LOCATELLI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
CA License # PHY30621
CA Medicaid PHA306210
Other 0521650 NABP #
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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