LUCKY STORES II LLC (NPI# 1760429427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760429427 |
| Entity Type | Organization |
| Organization Name | LUCKY STORES II LLC |
| Other Organization Name | SAVON DRUGS |
| Practice Address |
1590 Sycamore Ave Hercules CA 94547-1701 |
| Practice Telephone | 5102451440 |
| Practice Fax Number | 5102451803 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LORENZO TORRES (NEW STORE ENROLLMENTS) |
| Authorized Official Telephone | 8479164463 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | PHY44132 | CA | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0514504 | 01 |
| Other Name | Type Code |
|---|---|
| SAVON DRUGS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922047307 | Lucky Stores II LLC | Pharmacy | 2355 California Blvd, Napa, CA 94559-1062 | 2006-06-04 |
| 1770520108 | Lucky Stores II LLC | Pharmacy | 1465 Main St, Watsonville, CA 95076-3759 | 2006-06-02 |
| 1932146362 | Lucky Stores II LLC | Pharmacy | 700 Gray Ave, Yuba City, CA 95991-3621 | 2006-06-02 |
| 1689611014 | Lucky Stores II LLC | Pharmacy | 129 Bernal Rd, San Jose, CA 95119-1303 | 2006-06-02 |
| 1295772622 | Lucky Stores II LLC | Pharmacy | 291 Mccray St, Hollister, CA 95023-4094 | 2006-06-02 |
| 1760420780 | Lucky Stores II LLC | Pharmacy | 3100 E 9th St, Oakland, CA 94601 | 2006-06-02 |
| 1306883731 | Lucky Stores II LLC | Pharmacy | 1951 Holmes St, Livermore, CA 94550-6015 | 2006-06-02 |
| 1124065552 | Lucky Stores II LLC | Pharmacy | 4220 Florin Rd, Sacramento, CA 95823-2508 | 2006-06-02 |
| 1861439291 | Lucky Stores II LLC | Pharmacy | 5000 Mowry Ave, Fremont, CA 94538-1045 | 2006-06-02 |
| 1760429195 | Lucky Stores II LLC | Pharmacy | 1312 Trancas St, Napa, CA 94558-2912 | 2006-06-02 |
| Street Address |
1590 SYCAMORE AVE |
| City | HERCULES |
| State | CA |
| Zip Code | 94547-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275677346 | Save Mart Supermarkets | Pharmacy | 1590 Sycamore Ave, Hercules, CA 94547-1701 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768286 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4080 San Pablo Ave, Hercules, CA 94547 | 2020-01-06 |
| 1407415144 | Julita Chinyere Agwumezie | Pharmacist | 1590 Sycamore Avenue, Hercules, CA 94547 | 2019-06-06 |
| 1730545666 | Evelyn Gomez | Behavioral Analyst | 115 Starling Way, Hercules, CA 94547 | 2016-01-07 |
| 1730572264 | Laith Anwar Yacoub | Pharmacist | 530 Silver Maple Dr., Hercules, CA 94547 | 2015-03-09 |
| 1396171526 | Yeun Joo Kim | Dentist | 9 Arete Court, Hercules, CA 94547 | 2013-09-19 |
| 1568751527 | Sophie Chen | Dentist | 500 Alfred Nobel Drive, Suite 130, Hercules, CA 94547 | 2011-03-30 |
| 1962654517 | Jason M. Hataye | Student in an Organized Health Care Education/Training Program | 572 Turquoise Drive, Hercules, CA 94547 | 2008-10-15 |
| 1649454802 | Lovely C. Manlapaz | Dentist | 844 Willow Avenue, Suite - A6, Hercules, CA 94547 | 2007-12-24 |
| 1386823805 | Vincent T Chen | Dentist | 500 Alfred Nobel Dr., Ste. 280, Hercules, CA 94547 | 2007-11-01 |
| 1902950132 | Leonard Alexander Newman | Ophthalmology | 500 Alfred Noble Dr, Ste 225, Hercules, CA 94547 | 2007-01-23 |
| Find all providers in zip 94547 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.