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TULLY CLINIC PHARMACY NPI 1689700080


NPI Information

NPI: 1689700080
Provider Name: TULLY CLINIC PHARMACY

Doing Business As: TULLY MEDICAL CLINIC PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
1693 FLANIGAN DR
STE 104
SAN JOSE, CA
ZIP 95121
Phone: (408) 274-6698
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TULLY CLINIC PHARMACY is a community/retail pharmacy pharmacy in San Jose, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. TULLY CLINIC PHARMACY NPI is 1689700080. The provider is registered as an organization entity type.
The provider Is Doing Business As Tully Medical Clinic Pharmacy.

The provider's business location address is:

1693 FLANIGAN DR
STE 104
SAN JOSE, CA
ZIP 95121-683
Phone: (408) 274-6698
Fax: (408) 274-8580

The provider's authorized official is Dai Vo .
The authorized official title is Pic And President and has the following contact phone number (408) 274-6698.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 11/15/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPHY35754CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10598536OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2PHA357540MEDICAIDCALIFORNIA
35528310001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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