Provider Demographics
NPI:1851528996
Name:LIMA'S PROFESSIONAL PHARMACY, INC.
Entity Type:Organization
Organization Name:LIMA'S PROFESSIONAL PHARMACY, INC.
Other - Org Name:LIMA'S SPECIALTY CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:707-441-8538
Mailing Address - Street 1:2097 HARRISON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3211
Mailing Address - Country:US
Mailing Address - Phone:707-441-8530
Mailing Address - Fax:
Practice Address - Street 1:2097 HARRISON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3211
Practice Address - Country:US
Practice Address - Phone:707-441-8530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY499103336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy