Lucky Stores II LLC
NPI #1205873635 in San Bruno, California
Provider Information
- NPI Number
- 1205873635
- Entity Type
- Organization
- Organization Name
- Lucky Stores II LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jun 2, 2006
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 1322 EL CAMINO REAL
- City
- San Bruno
- State
- California
- ZIP Code
- 94066-1304
- Phone
- (650) 742-9737
Authorized Official
- Name
- LORENZO TORRES
- Title
- NEW STORE ENROLLMENTS
- Phone
- (847) 916-4463
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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