Provider Demographics
NPI:1093700882
Name:L.M.CALDWELL PHARMACIST
Entity Type:Organization
Organization Name:L.M.CALDWELL PHARMACIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:805-965-4528
Mailing Address - Street 1:1509 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2513
Mailing Address - Country:US
Mailing Address - Phone:805-965-4528
Mailing Address - Fax:805-966-1844
Practice Address - Street 1:1509 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2513
Practice Address - Country:US
Practice Address - Phone:805-965-4528
Practice Address - Fax:805-966-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY30911333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA194020Medicaid
CA0547161OtherNCPDP
CA0547161OtherNCPDP